ENERGY EFFICIENCY OPPORTUNITIES
IN ONTARIO HOSPITALS
In Cooperation with
FEBRUARY, 2006
Written by Jim Jefferson, President Sure Solutions Inc.
TABLE OF CONTENTS
EXECUTIVE SUMMARY ................................................................................................. I
INTRODUCTION............................................................................................................. 1
ONTARIO HOSPITAL PROFILES.................................................................................. 3
THE ONTARIO POWER AUTHORITY CONSERVATION BUREAU ............................. 4
BILL 21 THE ENERGY CONSERVATION RESPONSIBILITY ACT, 2005 .................... 5
PLANNED INFRASTRUCTURE CHANGES .................................................................. 6
RENEW ONTARIO ............................................................................................................ 6
ONTARIO MINISTRY OF HEALTH AND LONG-TERM CARE...................................... 8
HOSPITAL ENERGY PROFILES ................................................................................. 10
DATA COLLECTION METHODS ........................................................................................ 10
HCM GROUP INC. – ONTARIO HOSPITAL ENERGY USE DATA 2004/05 FISCAL YEAR ......... 11
SURE SOLUTIONS INC. – HOSPITAL PEER REVIEW – LARGE COMMUNITY HOSPITALS - MAY
2003 ........................................................................................................................... 16
NATURAL RESOURCES CANADA - “CONSUMPTION OF ENERGY SURVEY FOR UNIVERSITIES,
COLLEGES AND HOSPITALS, 2003” ................................................................................ 18
TORONTO REGIONAL CONSERVATION AUTHORITY – GREENING HEALTH CARE PROGRAM .. 19
TEACHING/ACUTE/AMBULATORY HOSPITALS ................................................................... 20
CHRONIC/REHAB HOSPITALS ......................................................................................... 21
ENERGY INNOVATORS INITIATIVE HEALTH CARE SURVEY – “COMPARING ENERGY
MANAGEMENT IN CANADIAN HEALTH CARE FACILITIES” ................................................... 22
ONTARIO HOSPITAL ASSOCIATION SURVEY - 2004/05 FISCAL YEAR CONSUMPTION 24
SUMMARY OF FINDINGS ................................................................................................. 27
THE BRITISH COLUMBIA MODEL.............................................................................. 34
SUCCESS STORIES .................................................................................................... 38
HEADWATERS HEALTH CENTRE............................................................................ 38
THE OTTAWA HOSPITAL ................................................................................................ 40
BLUEWATER HEALTH..................................................................................................... 43
LONDON HEALTH SCIENCES CENTRE AND ST JOSEPH'S HEALTH CARE, LONDON ............... 46
UNIVERSITY HEALTH NETWORK............................................................................ 50
ST. MICHAEL’S HOSPITAL - TORONTO................................................................... 52
SOME OTHER SUCCESS STORIES......................................................................... 55
THE CONSULTANT’S EXPERIENCE .......................................................................... 56
RECOMMENDATIONS................................................................................................. 63
EXECUTIVE SUMMARY
Ontario hospitals are the single largest provincial government expenditure. Ontario
hospitals will receive $12.27 billion this year (an increase of close to $1 billion from
announced budget funding of $11.3 billion in 2004/05). Due to the nature of their
operations, hospitals have the highest energy intensity of all publicly funded facilities.
Hospital utility costs are significant. A recent study of several large community
hospitals identified that utility costs represent approximately 47.34% of their total
plant operations and maintenance expenditures. Utility costs for Ontario hospitals
exceed $200 million per year. Utility costs represent up to 3% of a total hospital’s net
operating budget in Ontario. The average for Ontario hospitals is 1.73%. The average
expenditure for utilities in Ontario hospitals is approximately:
•
$8,037,000 per year for teaching hospitals;
•
$2,472,000 per year for large/medium community hospitals
•
$1,121,000 per year for continuing care/rehab/psych hospitals
•
$609,000 per year for smaller community hospitals
Electricity costs typically represent about 50% of total utility cost for hospitals or about
23.7% of total plant operations and maintenance costs. Since deregulation of the
electricity market in Ontario, hospital electrical prices have been protected under the
province’s regulated rate protection plan. The MUSH sector (Municipalities,
University/Colleges, Schools and Hospitals) will no longer be eligible under current
legislation for price protection beginning in April 2008. There is the potential for
dramatic price increases for hospital electrical costs at that time.
Much work has been done over the past few years in trying to raise awareness of the
benefits of energy conservation in Ontario hospitals through efforts such as the OHA’s
Green Healthcare/Energy Efficiency initiatives, the Canadian College of Health Service
Executives (CCHSE), The Toronto Regional Conservation Authority’s (TRCA) Greening
Health Care Program and Natural Resources Canada (NRCan) (a multitude of
programs for providing financial assistance, publications, training and tools).
There have been many success stories in conserving energy in Ontario hospitals, some
of which are highlighted as the ‘success story’ examples included in this report. They
have demonstrated that considerable opportunities exist for other hospitals to become
more efficient in their use of utilities. These success stories show that much can be
done to reduce utility consumption and thereby redirect savings to direct patient care
activities. Utility costs are not a fixed expensed.
Energy Efficiency Opportunities in Ontario Hospitals
i
Natural Resources Canada (December, 2001) in its report entitled “Comparing Energy
Management in Canadian Health Care Facilities” found that:
“Health care facilities can become much more proactive in lowering their
costs and reducing harmful GHG (green house gas) emissions through
improved management of their energy consumption and expenditures.”
As part of this study all Ontario hospitals were surveyed. Completed Hospital Energy
Efficiency Surveys were received from 69 of the 157 (43.9%) Ontario publicly funded
hospitals. The findings of that survey identified that energy intensity in Ontario’s
hospitals has increased since 2003 by 2.3%. The survey also showed widely varying
energy intensities between different types of hospitals and also between hospitals of the
same type.
So if energy conservation is a demonstrated effective way in reducing non-direct patient
care expenses why are Ontario hospitals not taking more steps to reduce consumption?
The survey used for this report asked all respondents to identify factors that hinder
conservation efforts. The responses were as follows:
•
Lack of staff resources
59.42%
•
No $ available internally for efficiency
55.07%
•
Lack of incentive funding
44.93%
•
Lack of Ministry of Health and Long Term
Care (MOHLTC) support (owing to a
shortage of internal resources and
operating funds to support energy
efficiency programs)
43.48%
Efficiency not a factor in capital planning
24.64%
•
The two largest barriers to energy efficiency reported by participating hospitals in the
survey identified were related to internal resources this includes the human resources to
manage the programs and in dollars to support the programs. It is apparent that
resource issues are having a significant effect on energy usage and intensity and in
return costs. Most hospitals identified that they did not have an energy management
plan in place and only 29% reported that they had a plan that had been approved by
their executive and Board of Directors.
Energy Efficiency Opportunities in Ontario Hospitals
ii
Effective energy management is not a one-time project but an ongoing program that
requires commitment at all levels of the organization. It is not a one-time activity but an
ongoing dedicated process. An energy management approach is necessary to ensure
efficiency. An energy management plan includes:
•
Understanding how energy is used and how it impacts overall costs on a daily
basis
•
Identifying measures for improving energy efficiency of existing facilities and
when designing new facilities
•
Keeping equipment efficient through proper maintenance and operational
practices
•
Improving purchasing practices for both energy and equipment
•
Improving awareness at all levels of the organization
Effective energy management should be seen as an investment that significantly helps
to reduce non-direct expenses allowing more dollars to be invested back into direct
patient care activities. There barriers not only exist internally but externally as well.
Natural Resources Canada (December, 2001) in its report entitled “Comparing Energy
Management in Canadian Health Care Facilities” also found that:
“Annual utility cost intensity is directly related to the frequency of
data collection of monitoring and tracking programs; the more
frequent the data collection; the lower the energy cost intensity.”
The report identified that health care facilities performing daily monitoring and
tracking of their utility usage (only 6% of facilities) had utility costs 14.6% lower
than the overall mean of respondents. Despite this demonstrated benefit they found
that only 54% of healthcare facilities did as little as check their utility bills to meter
readings on a monthly basis. Energy efficiency begins with awareness. It is important
to understand that “if you don’t measure it you can’t manage it!”
The Ontario MOHLTC collects data from hospitals regarding utility usage but recognizes
that the analysis of hospital utility usage could be strengthened.
Energy Efficiency Opportunities in Ontario Hospitals
iii
The average age of Ontario hospitals is 43 years old, which means that many are
reaching the end of their useful life and must be modernized or replaced. Most
hospitals were built at a time when capital cost was a greater consideration than
operating costs. In most cases hospital expansions have simply built on to the existing
systems. With rising utility costs it is important to understand that most facility related
systems use multiple times their original capital cost in energy over their lifetime. Total
life-cycle costs (energy, maintenance and labour requirements) are a key factor in a
hospitals ability to control ongoing operational costs.
$5.3 billion dollars has been committed to replacing and upgrading Ontario’s hospital
infrastructure over the next five years through the Renew Ontario program. This is a
key opportunity for Ontario hospitals to introduce energy efficiency standards for these
projects to improve hospital energy efficiency, thereby reducing the indirect cost of
hospital operations, allowing more money to be directed to direct patient care in the
communities they serve.
On November 3, 2005 the Ontario Government also introduced Bill 21, The Energy
Conservation Responsibility Act, 2005. The purpose of the Conservation Leadership
Initiative allows Ontario’s public sector lead the way in energy conservation. The Bill
will promote public sector leadership in conservation, help remove barriers to
conservation and strengthen the conservation culture in Ontario.
The Bill will ask public agencies such as hospitals to prepare and publish an energy
conservation plan. The Bill will also ask each public sector organization to consider
energy conservation through the acquisition of goods and services and when making
capital investments.
Conservation is expected to play a major role in Ontario as the province deals with
Canadian Kyoto commitments for reducing greenhouse gasses (GHG) and need to
invest heavily in its electrical infrastructure.
It is likely that publicly funded facilities such as hospitals will be included in upcoming
regulations in order to meet those commitments.
Energy Efficiency Opportunities in Ontario Hospitals
iv
INTRODUCTION
Ontario hospitals are the single largest provincial government expenditure. Over the
last few years the budgetary challenges in the institutional sector have been widely
reported. Government funded institutions have been faced with expenses that exceed
their incoming revenue streams. Hospitals annual operating costs are rising at about
8% per year (7.9% in 2005).
The Ontario government and the hospitals have a shared responsibility to manage
hospital costs. Over the years efforts to reduce costs in order to maintain and improve
direct patient care programs have resulted in many reductions to non-clinical areas.
It is apparent that even announced increased funding levels will not prevent budget
deficits without a considerable change in the hospital’s abilities to control expenses. As
some hospital expenses will escalate above announced funding levels it is imperative
that indirect expenses such as utility cost be reduced through demand reduction.
Hospital energy intensity in 2003 was the highest in the institutional sector (2.59 GJ/m2
vs. 2.19 for Ontario universities and 1.35 for colleges) due to the nature of their
operations.
In 2001 an Energy Innovators Initiative report entitled “Health Care Survey –
“Comparing Energy Management in Canadian Health Care Facilities” (Natural
Resources Canada - December, 2001) it stated one of most significant findings as:
“Health care facilities can become much more proactive in lowering
their costs and reducing harmful GHG (green house gas) emissions
through improved management of their energy consumption and
expenditures.”
It is reported that in countries where higher utility costs have been the norm such as
Sweden, that hospitals reach a consumption of 1.3 GJ/m2 (when adjusted for similar
operating conditions).
On November 3, 2005 the Ontario Government introduced Bill 21 the Energy
Conservation Responsibility Act, 2005. Under the Bill ministries, agencies and broader
public sector organizations (including hospitals) will be asked to prepare energy
conservation strategies on an on-going basis, report on energy consumption, proposed
conservation measures and progress on achieving results.
Energy Efficiency Opportunities in Ontario Hospitals
1
Schools, hospitals, colleges, universities and municipalities together represent more
than 5% of the energy use of the province as a whole. Energy represents one of their
largest non-core expenditures. “This legislation builds upon the important work that is
already being undertaken by many organizations in the broader public sector when it
comes to energy conservation and efficiency,” said Minister of Energy, Donna
Cansfield. “The public sector has an important role to play in supporting and advancing
conservation in Ontario.”
Since its inception in 1924, the OHA has influenced and helped shape health care
policy in Ontario, leading the way through changes, innovations, challenges and
opportunities. Through the Green Health Care initiative the OHA has helped to ensure
hospitals remain ecologically sustainable as we deal increasingly with issues relating to
water conservation and energy efficiency within the institutions. The OHA has longrecognized the importance of remaining environmentally responsible, and supporting its
members in their efforts to become more informed about how to better “green” their
organizations. OHA, in collaboration with Natural Resources Canada’s Office of Energy
Efficiency (OEE), and with the support of the Canadian College of Health Service
Executives (CCHSE), offers programs designed to promote and assist Ontario hospitals
with the implementation of energy saving solutions.
Sure Solutions Inc. was retained by the OHA to prepare this report - “Energy Efficiency
Opportunities within the Hospital Sector”. The study is funded through a grant provided
by the Ontario Power Authority, Conservation Bureau.
The purpose of the report is to increase awareness within the hospital community and
the Ontario government in regards to hospital energy usage and conservation
opportunities through a review of:
•
Energy usage in Ontario hospitals:
− examination of previously published studies
− the issuance of an Energy Efficiency Survey to all Ontario hospitals
•
Planned changes to current hospital infrastructure
•
Exploring the relationship of hospitals with their major funding body (Ontario
Ministry of Health and Long-Term Care) as it pertains to energy conservation
•
Examples of energy conservation best practice in Ontario hospitals
•
Consultant’s experiences in hospital energy efficiency
•
Successful programs from other provinces
And to provide recommendations for improving energy efficiency in Ontario’s hospitals.
Energy Efficiency Opportunities in Ontario Hospitals
2
ONTARIO HOSPITAL PROFILES
Ontario has approximately 157 publicly funded hospitals whose operational funding is
provided primarily from Ontario’s Ministry of Health and Long-Term Care. For the
purposes of this study the hospitals have been classified as follows:
•
Addiction and Mental Health
•
Continuing Care/Rehab
•
Community
63 hospitals
•
Teaching/Research
22 hospitals
•
Small Community
50 hospitals
14 hospitals
8 hospitals
Ontario hospitals will receive $12.27 billion this year (an increase of close to $1 billion
from announced budget funding of $11.3 billion in 2004/05), at least $12.6 billion in
2006/2007 and $13.1 billion in 2007/2008 in operational funding. Hospital utilities
encompass up to 3% of a hospitals operating budget.
In order to better understand and quantify the energy consumed by Ontario’s publicly
funded hospitals, as part of this study a survey (see Appendix A) was mailed by the
OHA to all Ontario hospitals on November 17, 2005. Completed surveys were returned
to, compiled and analyzed by Sure Solutions Inc. for the purposes of this study. The
study requested information in regards to all utility consumption for the fiscal year
2004/05. The survey was also requested input on current perceived barriers for energy
efficiency and the status of an energy conservation plan within the organization.
Energy Efficiency Opportunities in Ontario Hospitals
3
THE ONTARIO POWER AUTHORITY CONSERVATION BUREAU
This study is funded through a grant provided by the Ontario Power Authority,
Conservation Bureau (OPA). The Conservation Bureau is a fundamental part of the
OPA’s corporate structure. Situated within the OPA, and led by the Chief Energy
Conservation Officer, the Conservation Bureau plays a key role in promoting
conservation and delivering province-wide conservation programs.
Specifically, the mandate of the Conservation Bureau includes:
•
Developing province-wide conservation programs to help consumers save
energy and save money
•
Promoting energy conservation and the efficient use of electricity
•
Assessing the technical, economic and market potential for conservation in the
province
•
Reporting on Ontario’s progress in achieving its conservation targets and
assessing what further action is required
The Conservation Bureau is responsible for determining the potential for energy
conservation in Ontario, based on available technology and economic conditions. The
Conservation Bureau produces an annual report that is publicly delivered, helping focus
public attention on energy conservation, providing a venue to highlight significant
opportunities for action, whether by the government or the private sector.
The Conservation Bureau works with other institutions and stakeholders in the energy
sector to promote the adoption of energy-saving technologies, and to educate the public
on the importance of conservation. Providing conservation tools and opportunities to
consumers, either directly through province-wide programs, or through partners, will be
a key part of the bureau’s activities.
The Conservation Bureau, as part of the OPA, ensures that all opportunities for
conservation are taken into account.
Energy Efficiency Opportunities in Ontario Hospitals
4
BILL 21: THE ENERGY CONSERVATION RESPONSIBILITY ACT, 2005
On November 3, 2005 the Ontario Government introduced Bill 21, The Energy
Conservation Responsibility Act, 2005. If passed, the legislation will implement two
major conservation initiatives in Ontario. The first is the introduction of smart metering
technology in Ontario; the second is the introduction of Conservation Leadership
Legislation.
The purpose of the Energy Conservation Leadership Initiative ensures that Ontario’s
public sector (ministries, agencies and broader public sector organizations – including
hospitals) lead the way in energy conservation. The Bill will promote public sector
leadership in conservation, help remove barriers to conservation and strengthen the
conservation culture in Ontario.
Schools, hospitals, colleges, universities and municipalities together represent more
than 5% of the energy use of the province as a whole. Energy represents one of their
largest non-core expenditures.
The Bill will also ask each public sector organization to consider energy conservation
through the acquisition of goods and services and when making capital investments.
“This legislation builds upon the important work that is already being undertaken by
many organizations in the broader public sector when it comes to energy conservation
and efficiency,” said Minister of Energy, Donna Cansfield. “The public sector has an
important role to play in supporting and advancing conservation in Ontario.”
Conservation is expected to play a major role in Ontario as the province deals with
Canadian Kyoto commitments for reduction of GHG’s and the need to invest heavily in
its electrical infrastructure. In a report submitted to the province and made public on
December 9, 2005, the Ontario Power Authority estimated that it will cost $83 billion to
rebuild Ontario’s electricity sector over the next 20 years. Conservation will play an
important part in reducing the impact on consumers. The OPA’s report identified that
conservation is the lowest cost option for addressing Ontario’s electrical needs and
recommended spending between $5 to $11 Billion on conservation.
Ontario has committed to reducing electricity consumption in the province by 5% by
2007. It has committed to reduce electricity in government owned facilities by 10%.
Under the Kyoto agreement Canada has committed to reducing greenhouse gas
emissions by 6% from 1990 levels by 2012. Canadian emissions levels are currently
24% above 1990 levels. It is likely that publicly funded facilities such as hospitals will be
included in upcoming regulations in order to meet those commitments.
Ontario Power Authority officials say that consumption per person in the province is
expected to decline, they nevertheless foresee total demand rising 0.9% a year
because of Ontario's growing population and expanding economy.
Energy Efficiency Opportunities in Ontario Hospitals
5
PLANNED INFRASTRUCTURE CHANGES
Renew Ontario
Renew Ontario is the province’s five-year plan by the government and its partners to
invest more than $30 billion in Ontario’s public infrastructure by the year 2010. The
Ministry of Public Infrastructure Renewal program is intended to upgrade Ontario’s
infrastructure to meet the needs of its citizens and accommodate millions of new people
who will settle in Ontario over the next 25 years.
The average age of Ontario hospitals is 43 years old, this means many hospitals are
reaching the end of their useful life and must be modernized or replaced. The total
value of hospital projects begun in the next five years will be approximately $5.3
billion, including community-share contributions.
This is a key opportunity for Ontario to introduce energy efficiency standards for these
projects to improve hospital energy efficiency, thereby reducing the indirect cost of
hospital operations, allowing more money to be directed to direct patient care in the
communities they serve. It is also an opportunity for Ontario to meet it’s commitments
for energy reduction and reduction of GHG’s. The passing of The Energy Conservation
Responsibility Act, 2005 into law will require energy conservation to be addressed in all
new capital projects and the acquisition of goods and services for these facilities.
The government’s goal is to modernize Ontario’s health infrastructure by updating
equipment and expanding capacity to meet the needs of our growing and aging
population. The five-year infrastructure investment plan is a blueprint that supports the
government’s goal of achieving better health for Ontarians. Some highlights include:
•
Funding to finish 39 major projects with a value of at least $25 million
•
The start of 66 new projects to upgrade and expand hospitals to provide better
services in high-growth areas, modernize older hospitals and reduce wait times.
– Thirty-three projects will be started over the next 24 months; 30 per cent of
these are large complex projects.
– Another 33 projects will be started during the remaining three years of the
plan and over 35 per cent of these are large and complex.
In the past, Ontario’s infrastructure investments were made on a year-by-year basis,
with little attempt to co-ordinate capital projects across government ministries or
economic sectors. The principal source of funding was the government, and most
projects were funded from current revenues, with the entire cost counted during the
construction of the project, not paid for over the life of the asset.
Energy Efficiency Opportunities in Ontario Hospitals
6
The Ministry of Public Infrastructure Renewal, in collaboration with the MOHLTC will
determine the financing methods for each project. A significant number of the larger
complex projects will be financed and built using alternative financing and procurement
methods.
These strategies will take advantage of private-sector capital, expertise and efficiencies
to do far more in the next few years than what may have been done in the past, and to
do it on time and on budget.
New sources of financing will be accessed through Infrastructure Renewal Bonds, and
from partnerships with financial institutions and pension funds.
A new management framework has been introduced for larger, complex projects.
These projects will require a fully developed business case to demonstrate the public
need and the public benefit before they proceed, as well as appropriate transfer of risk
and use of private-sector expertise. All major projects will have to meet these
requirements.
A new agency, the Ontario Infrastructure Projects Corporation, will ensure that the
delivery of large-scale alternative finance and procurement projects are received
successfully.
In many cases these AFP financed projects will involve private sector partners who will
design, build and operate the facilities. The involvement in private sector partners may
also help to increase energy efficiency as private partners typically take a business
approach to reducing total life-cycle costs.
Regardless of the finance methods Ontario hospitals will be public hospitals, owned by
the people of Ontario and controlled by public hospital boards.
Energy Efficiency Opportunities in Ontario Hospitals
7
ONTARIO MINISTRY OF HEALTH AND LONG-TERM CARE
Operational
The MOHLTC provides primary operating revenues to Ontario’s hospitals and oversees
all hospital operations in accordance to The Public Hospitals Act.
From an operational perspective the MOHLTC collects information from each hospital in
regards to utility usage and cost. Ministry officials do not analyze utility costs to the
same level as other patient care expenses. The Ministry does not collect hospital area
data (square footage or square meters).
Sure Solutions could not obtain data from the MOHLTC in regards to hospital utility data
within the time period required for the completion of this report.
Capital Planning
An interview was conducted with Mr. Bill Bailey, Director, Capital Planning and
Strategies Branch and Mr. Michael Parzei, Manager, Capital Planning in regards to
ministry involvement in ensuring energy efficiency in Ontario hospitals.
The Capital Planning and Strategies Branch is responsible for the coordination of the
Ministry's capital plan, and regular reporting of the Ministry's capital financial status to
the central agencies. This branch also manages the capital planning process, capital
policy development, health capital strategies, and alternative financing strategies for the
MOHLTC. In addition, it provides technical advice and capital funding to health care
facilities, and holds controllership functions for appropriation control, financial monitoring
and multi-year forecasting on the Health Capital Program.
The Public Hospitals Act requires all hospital projects over $100,000 in cost to be
reviewed and approved by the ministry. Projects are typically submitted to the
MOHLTC as:
•
MOHLTC Funded Projects:
– Major Capital (over $5 million).
– Minor Capital – from the $60 million Health Infrastructure Renewal Fund
•
Hospital “Own Funds” Projects
– Hospital projects exceeding $100,000 with no MOHLTC capital funding
In 2003/04 the MOHLTC implemented a two-stage approval process for energy
efficiency projects. The first step of the process is the effective planning phase.
Energy Efficiency Opportunities in Ontario Hospitals
8
This phase requires hospitals to submit a business case supporting the project which
results in a more holistic approach. This can be a complicated process and many
hospitals may have to reexamine their proposal at the request of the MOHLTC. The
MOHLTC are currently rewriting a planning manual that would address:
•
Benchmarks
•
Lifecycle costs
•
Building a better business case
A planning manual shared with hospitals would create a more efficient application
system for the Health Infrastructure Renewal Fund. The current process can be time
consuming.
The Capital Planning and Strategies Branch has also increased project management
support for major capital projects from the previous limit of $65,000 to 2% of project
cost. This allows more focus to be placed on effectively planning, managing and
commissioning the project to ensure higher levels of energy efficiency.
Energy Efficiency Opportunities in Ontario Hospitals
9
HOSPITAL ENERGY PROFILES
Data Collection Methods
All Ontario hospitals were surveyed for gross area, and total utility consumption. The
survey used is included on the next page.
The results were compared and reviewed with various alternate sources of recent
information. The sources of alternate information used were:
•
Ontario Hospital Energy Use Data 2004/05
− HCM Group Inc.
•
Sure Solutions Inc. Hospital Peer Review
– Large Community Hospitals
•
Consumption of Energy Survey for Universities, Colleges and Hospitals, 2003
− Natural Resources Canada
•
Toronto Regional Conservation Authority
− Data from participating hospitals in their Greening Health Care program
•
The Energy Innovators Initiative Health Care Survey – “Comparing Energy
Management in Canadian Health Care Facilities” - Natural Resources Canada
(December, 2001) was also reviewed. The report utilized data received from
Canadian hospitals for the 1997/98 fiscal year. The report collected information
in regards to energy costs. Escalations in the cost of utilities since that time do
not allow for an accurate comparison to more recent reports however the report
is still a valuable tool in identifying energy comparisons between hospitals with
energy conservation programs and those without.
Energy Efficiency Opportunities in Ontario Hospitals
10
HCM Group Inc. – Ontario Hospital Energy Use Data 2004/05 Fiscal Year
2004/05 fiscal year (April 1, 2004 to March 31, 2005) utility cost information was
provided to Sure Solutions Inc. by the HCM Group Inc. for 78 of 157 Ontario hospitals
that they had compiled data (source: MIS Trial Balance submissions).
The results showed that for:
•
41 Large/Medium Community Hospitals the mean percentage of total net
operating budget was 1.61% ($2,472,000 per facility)
•
11 Smaller Community Hospitals the mean percentage of total net operating
budget was 1.81% ($609,000 per facility)
•
13 Teaching Hospitals the mean percentage of total net operating dollars was
1.84% ($8,037,000 per facility)
•
13 Continuing Care/Rehab/Psych Hospitals the mean percentage of total net
operating dollars was 1.87% ($1,121,000 per facility)
Electricity Cost for the 78 hospitals totaled $109,631,339 or 0.84% of total net operating
budgets.
The cost of Natural Gas or purchased steam totaled $88,620,847 or 0.68% of total net
operating budgets.
Water/sewage charges totaled $23,073,179 or 0.18% of total net operating budgets.
Total utility costs for the 78 (of 157) hospitals totaled $227,117,530.
Energy Efficiency Opportunities in Ontario Hospitals
11
Ontario Hospital Energy
Usage
2004/05 Sample
Purchased Steam/Heat ($
000's)
Fuel Oil Cost ($ 000's)
Natural Gas ($ 000's)
Electricity ($ 000's)
Water ($ 000's)
Non-Medical Gases ($
000's)
Total Utilities Cost ($
000's)
Natural Gas (000's CSM)
Electricity (megawatts)
Water Consumption Cubic Litres
Utilities % of net
operating $
Large/Medium
Community
#
Total
Mean
Median
5
33
41
41
41
$1,106
$1,504
$37,371
$50,039
$11,211
$221
$46
$911
$1,220
$273
$49
$7
$758
$1,000
$241
41
$126
$3
$0
41
$101,357
$2,472
$2,023
28
28
83,218
387,305
2,972
13,832
2,089
10,719
26
460,427
17,709
83
1.61%
1.59%
41
Source: MIS Trial Balance submissions
Prepared by HCM Group,
Inc.
Energy Efficiency Opportunities in Ontario Hospitals
12
Ontario Hospital Energy
Usage
Smaller
Community
2004/05 Sample
Purchased Steam/Heat ($
000's)
Fuel Oil Cost ($ 000's)
Natural Gas ($ 000's)
Electricity ($ 000's)
Water ($ 000's)
Non-Medical Gases ($ 000's)
Total Utilities Cost ($ 000's)
#
Total
Mean
Median
4
$18
11 $2,735
11 $3,219
11
$720
11
$9
11 $6,700
$4
$249
$293
$65
$1
$609
$0
$265
$243
$57
$0
$594
8 5,803
8 22,511
725
2,814
533
2,686
26
31
1.81%
1.81%
Natural Gas (000's CSM)
Electricity (megawatts)
Water Consumption - Cubic
Litres
Utilities % of net operating $
7
11
179
Source: MIS Trial Balance
submissions
Prepared by HCM Group, Inc.
Energy Efficiency Opportunities in Ontario Hospitals
13
Ontario Hospital Energy
Usage
Teaching
Hospitals
2004/05 Sample
Purchased Steam/Heat ($
000's)
Fuel Oil Cost ($ 000's)
Natural Gas ($ 000's)
Electricity ($ 000's)
Water ($ 000's)
Non-Medical Gases ($ 000's)
Total Utilities Cost ($ 000's)
#
Total
Mean Median
11 $21,912
10
$1,985
12 $19,116
13 $49,887
13
$9,710
13
$1,873
13 $104,483
$1,992
$199
$1,593
$3,837
$747
$144
$8,037
$1,461
$21
$1,196
$2,862
$597
$6
$5,706
Natural Gas (000's CSM)
Electricity (megawatts)
Water Consumption - Cubic
Litres
7
10
40,712
377,863
5,816
37,786
4,913
35,224
10
28,426
2,843
20
Utilities % of net operating $
13
1.84%
1.85%
Source: MIS Trial Balance
submissions
Prepared by HCM Group, Inc.
Energy Efficiency Opportunities in Ontario Hospitals
14
CCC/Rehab/
Psych
Hospitals
Ontario Hospital Energy
Usage
2004/05 Sample
#
Total
3
8
12
13
13
13
13
$525
$277
$5,856
$6,487
$1,432
$1
$14,578
$175
$35
$488
$499
$110
$0
$1,121
$283
$25
$389
$516
$105
$0
$874
Natural Gas (000's CSM)
Electricity (megawatts)
Water Consumption - Cubic
Litres
11
10
16,264
77,818
1,479
7,782
1,336
5,198
11
1,016
92
47
Utilities % of net operating $
13
1.87%
1.93%
Purchased Steam/Heat ($
000's)
Fuel Oil Cost ($ 000's)
Natural Gas ($ 000's)
Electricity ($ 000's)
Water ($ 000's)
Non-Medical Gases ($ 000's)
Total Utilities Cost ($ 000's)
Mean Median
Source: MIS Trial Balance
submissions
Prepared by HCM Group, Inc.
Energy Efficiency Opportunities in Ontario Hospitals
15
Sure Solutions Inc. – Hospital Peer Review – Large Community Hospitals - May
2003
In May 2003 Sure Solutions surveyed large community hospitals as part of a facilities
management operational review for a hospital client. Budget data was received back
from 7 hospitals for the 2003/04 fiscal year (April 1, 2003 to March 31, 2004).
The results showed that:
•
The average area for the responding hospitals was 1,066,650 ft.²
•
The average cost for plant operations and maintenance in each hospitals was
$6,424,026 per year
•
That total utility costs represented on average $3,041,038 or:
− 47.34% of total plant operations and maintenance expenditures
− $2.86 per ft.²
•
Electricity costs averaged $1,522,614 per year or
− 23.70% of total plant operations and maintenance expenditures
− 50.07% of total utility cost
− $1.47 per ft.²
•
Natural gas costs averaged $1,210,264 per year or
− 18.84% of total plant operations and maintenance expenditures
− 39.8% of total utility cost
− $1.11 per ft.²
•
Water and sewage costs averaged $308,160 or
− 4.8% of total plant operations and maintenance expenditures
− 10.13% of total utility cost
− $0.28 per ft.²
Energy Efficiency Opportunities in Ontario Hospitals
16
Maintenance
And Plant
Operations
Total
Maintenance
Utilities
Physical Plant Operations
Survey of Large Public General Community Hospitals –
May/03
Hospital 'A'
Hospital 'B'
Hospital 'C'
Hospital 'D'
Hospital 'E'
Hospital 'F'
Hospital
'G'
Sq. Ft.
932,600
1,491,895
1,050,000
933,980
1,200,000
1,125,147
732,930
1,066,650
annual budget
$3,289,320
$7,045,529
$4,000,000
$3,538,488
$4,324,507
$3,686,782
$3,798,372
$4,240,428
Average
electricity
$1,630,000
$1,691,559
$1,700,000
$1,248,250
$1,107,329
$1,931,160
$1,350,000
$1,522,614
Elec. $/sq.ft.
$1.75
$1.13
$1.62
$1.34
$0.92
$1.72
$1.84
$1.47
natural gas
$785,000
$2,976,462
$800,000
$1,326,655
$513,000
$1,120,728
$950,000
$1,210,264
NG $/sq.ft.
$0.84
$2.00
$0.76
$1.42
$0.43
$1.00
$1.30
$1.11
water and sewage
$342,000
$567,590
$300,000
$223,650
$259,000
$269,880
$195,000
$308,160
W&S $/sq.ft.
$0.37
$0.38
$0.29
$0.24
$0.22
$0.24
$0.27
$0.28
total utility $
$2,757,000
$5,235,611
$2,800,000
$2,798,555
$1,879,329
$3,321,768
$2,495,000
$3,041,038
total utility $ / sq. ft.
$2.96
$3.51
$2.67
$3.00
$1.57
$2.95
$3.40
$2.86
Annual Budget
$3,050,300
$3,608,320
$2,000,000
$1,861,822
$1,285,868
$1,176,446
$2,302,427
$2,183,598
Budget Total
$6,339,620
$10,653,849
$6,000,000
$5,400,310
$5,610,375
$4,863,228
$6,100,799
$6,424,026
$ / sq. ft.
$6.80
$7.14
$5.71
$5.78
$4.68
$4.32
$8.32
$6.11
$ / sq. meter
$73.17
$76.87
$61.51
$62.24
$50.32
$46.52
$89.60
$65.75
Energy Efficiency Opportunities in Ontario Hospitals
% of Total
Physical
Plant/Maint.
Cost
23.70%
18.84%
4.80%
47.34%
17
Natural Resources Canada – “Consumption of Energy Survey for Universities,
Colleges and Hospitals, 2003”
In 2004 Statistics Canada undertook, on behalf of the Office of Energy Efficiency of
Natural Resources Canada, the first consumption of Energy Survey for universities,
colleges and hospitals. The primary objective of the survey was to gather 2003 energy
consumption data for this sector as these were identified as key sectors in the
development of Office of Energy Efficiency programs. The survey was sent to 742
hospital complexes across Canada (199 in Ontario). Only complexes with 50 or more
employees were surveyed. 500 hospital complexes responded to the survey (the
number for Ontario is not stated).
Survey Results
Hospital energy intensity in 2003 was the highest in the institutional sector in Ontario at
2.59 GJ/m2 (vs. 2.19 for universities and 1.35 for colleges). Energy intensity for all
Canadian hospitals was 2.65 GJ/m2.
Energy Efficiency Opportunities in Ontario Hospitals
18
Toronto Regional Conservation Authority – Greening Health Care Program
The Toronto Regional Conservation Authority is a non-profit organization under the
auspices of the Conservation Authorities Act. 23 hospital sites have been working
together on the Greening Health Care pilot program, benchmarking energy and water
efficiency, and sharing knowledge to take on new energy and environmental
management projects. The program extends beyond Toronto’s borders to encompass
participating hospitals from St. Catharines to Oshawa, Ontario and as far north as
Barrie.
The following data was received from them for total ekWh / m².
Toronto and Region Conservation Authority
Greening Health Care Program Participants
2004
Chronic Care/Rehab.
Facility
A
B
C
Average
Total
ekWh/m²
40.81
43.71
51.85
45.46
Teaching/Acute/Ambulatory
Facility
A
B
C
D
E
Average
Total
ekWh/m²
45.2
48.09
48.87
68.55
80.01
58.144
The reported average energy intensity of participating hospitals in the TRCA program
appear to be much lower than provincial averages from the OHA survey conducted for
this report, perhaps demonstrating the value of benchmarking and awareness in
reducing total energy consumption and costs.
Energy Efficiency Opportunities in Ontario Hospitals
19
Greening Health Care – Consumption and Demand Benchmarking
Teaching/Acute/Ambulatory Hospitals
400
350
300
250
200
150
100
50
Teaching / Acute / Ambulatory 1
Teaching / Acute / Ambulatory 2
Teaching / Acute / Ambulatory 3
Teaching / Acute / Ambulatory 4
Teaching / Acute / Ambulatory 5
Teaching / Acute / Ambulatory 6
Teaching / Acute / Ambulatory 7
Teaching / Acute / Ambulatory 8
Teaching / Acute / Ambulatory 9
9
8
A
cu
te
/
Te
ac
hi
ng
/
Te
ac
hi
ng
A
m
bu
la
to
ry
/
A
m
bu
la
to
ry
/
A
cu
te
A
cu
te
Te
ac
hi
ng
/
A
cu
te
/
Electricity Consumption
(kWh / m2)
209
223
223
243
245
245
265
302
347
Energy Efficiency Opportunities in Ontario Hospitals
7
6
/
A
m
bu
la
to
ry
/
/
A
cu
te
Te
ac
hi
ng
/
Electricity Consumption
Facility
A
m
bu
la
to
ry
5
4
A
m
bu
la
to
ry
/
A
cu
te
Te
ac
hi
ng
/
Te
ac
hi
ng
A
m
bu
la
to
ry
3
2
A
m
bu
la
to
ry
/
A
cu
te
/
Te
ac
hi
ng
/
Te
ac
hi
ng
Te
ac
hi
ng
/
A
cu
te
A
cu
te
/
/
A
m
bu
la
to
ry
A
m
bu
la
to
ry
1
0
Demand
Demand
(W / m2)
31
34
34
38
44
39
39
45
56
20
The Teaching/Acute/Ambulatory participants in the TRCA Greening Healthcare Program had an
average electrical demand of 40 W/m².
Chronic/Rehab Hospitals
250
200
150
100
50
0
Chronic / Rehab Chronic / Rehab Chronic / Rehab Chronic / Rehab Chronic / Rehab Chronic / Rehab Chronic / Rehab
1
2
3
4
5
6
7
Electricity Consumption
Facility
Demand
Electricity Consumption
Demand
(kWh / m2)
(W / m2)
Chronic / Rehab 1
127
41
Chronic / Rehab 2
Chronic / Rehab 3
153
176
27
27
Chronic / Rehab 4
Chronic / Rehab 5
182
182
29
29
Chronic / Rehab 6
Chronic / Rehab 7
196
209
42
40
The Teaching/Acute/Ambulatory participants in the TRCA Greening Healthcare Program had an
average electrical demand of 33.6 W/m².
Energy Efficiency Opportunities in Ontario Hospitals
21
Energy Innovators Initiative Health Care Survey – “Comparing Energy
Management in Canadian Health Care Facilities”
Natural Resources Canada (December, 2001)
The Energy Innovators Initiative was established by Natural Resources Canada
(NRCan) to implement new energy efficiency measures related to the Canadian
government’s adoption and commitment to the Kyoto Protocol in 1997. As part of this
commitment to the international issue of climate change Canada agreed to reduce its
GHG emissions to 6% below 1990 levels between the years 2008 and 2012.
In order to assess energy efficiency practices and increase awareness levels in the
Canadian health care sector a survey was developed in cooperation with the Canadian
College of Health Service Executives (CCHSE) and endorsed by the Canadian
Healthcare Engineering Society (CHES). The survey was issued to 879 Canadian
health care facilities in 1998.
The results of that study found that hospitals facilities spent about 1.6% of their overall
budget on energy. Much of the study was completed in dollars spent so the data (cost /
ft² etc.) is dated. There were some interesting findings from the survey in regards to the
existence and benefits of energy awareness programs and utility monitoring and
tracking programs.
The findings from the study indicated that only 35% of those surveyed reported having
and energy awareness program in place.
Monitoring and Tracking
•
8% monitored utilities on a quarterly basis
•
68% of respondents reported that they monitored utility use monthly
•
11% undertake weekly monitoring
•
Only 54% of respondents performed some type of utility monitoring and tracking
(as simple as confirming monthly utility bills with meter readings)
•
Only 6% of respondents followed a daily monitoring regime
One of the most significant findings of the study revealed that;
“Annual utility cost intensity is directly related to the frequency of data
collection of monitoring and tracking programs; the more frequent the
data collection; the lower the energy cost intensity.”
Energy Efficiency Opportunities in Ontario Hospitals
22
Facilities assembling data on a daily basis reported mean energy cost intensity
14.6% lower than the overall mean.
$24.00
$23.00
$22.00
Series1
$21.00
$20.00
$19.00
$18.00
Mean Overall
Dedicated
Resources
Resources
Using M&T
Resources
Using Daily
M&T
The report listed the most significant findings as:
•
Health care facilities can become much more proactive in lowering their costs
and reducing harmful GHG emissions through improved management of their
energy consumption and expenditures
•
There is a great variation in energy use performance amoung various facility
types as well as within similar facilities
•
The use of Monitoring and Tracking systems operated by trained staff tended to
result in better than average energy performance
•
Annual utility cost intensity is directly related to the frequency of data collection
of monitoring and tracking programs. The more frequent the data collection, the
lower the energy cost intensity
•
Interestingly, 94% of the facilities using dedicated resources ranked ongoing
energy management training as “important” or “very important”. Nearly half of
those were registered as Energy Innovators
Energy Efficiency Opportunities in Ontario Hospitals
23
OHA SURVEY - 2004/05 FISCAL YEAR CONSUMPTION
Received, analyzed and reviewed by Sure Solutions Inc.
Completed Hospital Energy Efficiency Surveys were received from 69 of the 157
(43.7%) Ontario publicly funded hospitals. The study requested information in regards
to all utility consumption for the fiscal year 2004/05. The breakdown of returned
completed surveys is as follows:
•
Addiction and Mental Health
5 of 14 hospitals (36%)
•
Chronic/Continuing Care/Rehab
4 of 8 hospitals (50%)
•
Community
32 of 63 hospitals (50%)
•
Teaching/Research
11 of 22 hospitals (50%)
•
Small Community
17 of 50 hospitals (34%)
Energy Efficiency Opportunities in Ontario Hospitals
24
The following chart summarizes energy information compiled from completed OHA survey returns.
Survey Results:
Addiction/Mental Health
Continuing Care/Rehab
Community
Teaching
Small
All - OHA survey
NRCan 2003
# of
Hospitals
Returning
Survey
5
4
32
11
17
69
Average
Area (ft.²)
Average
Area
(m.²)
357,428
330,534
459,016
2,378,469
76,092
33,206
30,708
42,644
220,967
7,069
Energy Efficiency Opportunities in Ontario Hospitals
Average
Electricity
(kWh)
7,052,029
4,939,076
9,535,529
53,484,832
1,642,228
electricity
(kWh / ft.2)
19.73
14.94
20.77
22.49
21.58
Average
Heating
Energy
ekWh
14,976,407
13,060,793
20,641,332
117,739,363
3,449,891
Heating
Energy
ekWh /
ft2
TOTAL
ENERGY
(ekWh)/ft
²
TOTAL
Energy
ekWh/m²
TOTAL
Energy
Gj/m²
41.90
39.51
44.97
49.50
45.34
61.63
54.46
65.74
71.99
66.92
68.45
663.3846
586.1691
707.6458
774.8858
720.3304
736.7781
2.39
2.11
2.55
2.79
2.59
2.65
2.59
25
OHA Survey
The survey asked all respondents to identify factors that hinder conservation efforts.
The responses were as follows:
•
lack of staff resources
59.42%
•
efficiency not a factor in capital planning
24.64%
•
no money available internally for efficiency
55.07%
•
lack of MOHLTC support
(owing to a shortage of
internal resources and
operating funds to support
energy efficiency
programs)
43.48%
lack of incentive programs
44.93%
•
The survey stated that:
The Ontario Government introduced legislation on November 3, 2005 entitled Energy
Conservation Responsibility Act, 2005. Hospitals will be required to prepare energy
conservation reports on a regular basis, and report on energy consumption, proposed
conservation measures, and progress on achieving results.
Respondents were asked:
Does your hospital have an Energy Conservation Plan?
•
43.48% reported “Yes”
If so, has it been approved by the hospital’s executive and Board of Directors?
•
28.99% reported “Yes”
Energy Efficiency Opportunities in Ontario Hospitals
26
Summary of Findings
The utility component for Ontario hospitals represents about 1.73% of total hospital net
operating budgets by cost.
•
Electricity totals 0.84% of total hospital net operating budgets.
•
Electricity represents about 31.3% of the total energy consumed in Ontario’s
hospitals and is about 48% of total utility budgets by cost.
•
Natural Gas or purchased steam totals 0.68% of total hospital net operating
budgets by cost.
•
Natural gas, purchased steam and heat and other fuels represent about 68.7%
of total energy consumed and about 39% of total utility budget by cost.
•
Water/sewage charges totals 0.18% of total hospital net operating budgets and
about 10% of total utility budget by cost.
According to the Consumption of Energy Survey for Universities, Colleges and
Hospitals, 2003, Natural Resources Canada hospital energy intensity in 2003 was the
highest in the institutional sector in Ontario at 2.59 GJ/m2 (vs. 2.19 for universities and
1.35 for colleges).
The OHA Survey, 2005 issued for the purposes of this study shows that Ontario hospital
energy intensity in 2004/2005 is 2.65 GJ/m2 or 68.45 ekWh / ft.², broken down by
hospital type as follows:
•
Addiction and Mental Health
2.39
GJ/m2 (61.63 ekWh / ft.²)
•
Chronic/Continuing Care/Rehab
2.11
GJ/m2 (54.46 ekWh / ft.²)
•
Community
2.55
GJ/m2 (65.74 ekWh / ft.²)
•
Teaching
2.79
GJ/m2 (71.99 ekWh / ft.²)
•
Small
2.59
GJ/m2 (66.92 ekWh / ft.²)
Energy Efficiency Opportunities in Ontario Hospitals
27
Based on the OHA survey results it appears that Ontario hospitals energy
consumption intensity (energy/square meter) has increased since 2003 by 2.3 %.
Note that weather data was not analyzed for comparison purposes and may have
contributed to the increase.
Ontario Hospital Energy Efficiency
NRCan 2003
All - OHA survey
Small
Teaching
Community
Continuing Care / Rehab
Addiction / Mental Health
0.00
0.50
1.00
1.50
2.00
2.50
3.00
GJ / m2
Small
Teaching
Community
Continuing
Care /
Rehab
Addiction
and Mental
Health
ekWh / ft2
Total Energy Intensity
80.00
70.00
60.00
50.00
40.00
30.00
20.00
10.00
0.00
heating ekWh/ft2
electricity kWh/ft2
Energy Efficiency Opportunities in Ontario Hospitals
28
It is also interesting to note that the average energy intensity for participants in the
Toronto Regional Conservation Authority - Greening Health Care program is
significantly lower than the average energy intensity identified in the OHA Survey and
previous studies (45.46 ekWh/ft² for Chronic Care/Rehabilitation and 58.144 ekWh/ft²
for Teaching/Acute/Ambulatory).
The hospitals responding to the OHA survey had a total annual electricity usage of
76,653,694 kWh for the fiscal year 2004/05. The total heating energy for the
responding hospitals is 169,867,786 ekWh.
The average energy usage for each responding hospital type was:
Average
Electricity
(kWh)
Average
Heating
Energy (ekWh)
Average
Total Area
(sq. ft.)
Addiction and Mental Health
7,052,029
14,976,407
357,428
Continuing Care/Rehab
4,939,076
13,060,793
330,534
Community
9,535,529
20,641,332
459,016
53,484,832
117,739,363
2,378,469
1,642,228
3,449,891
76,092
Teaching
Small
Energy Efficiency Opportunities in Ontario Hospitals
29
Based on the information obtained from participating hospitals the data was extrapolated to estimate
totals for all on Ontario’s 157 hospitals. The following chart utilizes averages from survey results for
each hospital type and multiplies them by the number of organizations in each classification.
Average
Area (ft.²)
Average
Area
(m.²)
Projected
Total Annual
Electricity
(kWh)
Projected
Total Annual
Heating
Energy
(ekWh)
14
357,428
33,206
98,728,406
209,669,692
308,398,098
1,110,233
8
330,534
30,708
39,512,610
104,486,344
143,998,954
225,969
63
459,016
42,644
610,273,856
1,321,045,261
1,931,319,117
6,457,630
22
2,378,469
220,967
1,176,666,300
2,590,265,986
3,766,932,286
12,776,980
50
76,092
7,069
82,111,406
2,007,292,578
31.3%
172,494,540
4,397,961,823
68.7%
254,605,946
6,405,254,401
848,888
21,419,701
Total # of
Hospitals
Projected
TOTAL
Annual
ENERGY
(ekWh)
Gigajoules
total
Estimated Sector Energy - Ontario
Addiction and Mental Health
Continuing Care/Rehab
Community
Teaching
Small
Estimated Total Area - All Ontario
Hospitals:
ft.²
8,654,495 m.²
93,156,212
Energy Efficiency Opportunities in Ontario Hospitals
30
Water Consumption
Water consumption data was received from 56 hospitals. Several smaller facilities (not
included) reported being billed on a fixed rate.
Reported water usage for hospitals from the OHA survey was:
# of Hospitals
Reporting
Average Water
per Hospital
(m³)
Ratio - Water
Consumed / Area
(m³ / m²)
Addiction/Mental Health
2
47,448
Continuing Care/Rehab
4
57,404
Community
28
140,420
Teaching
10
540,002
Small
12
21,268
1.51
1.87
3.57
2.56
2.98
Survey Results:
Survey results for water usage between hospitals in the same classification differed
more than any other utility (when compared on consumption / area). The following chart
demonstrates the lowest and highest water usage (water m³ / area m²) for each
category.
Lowest Ratio (water m³ / area m²)
Highest Ratio (water m³ / area m²)
Addiction/Mental Health
0.99
1.75
Continuing Care/Rehab
1.26
4.36
Community
0.53
8.48
Teaching
1.48
6.73
Small
1.90
5.46
Survey Results:
The results indicate that there are substantial opportunities for water conservation and a
reduction in water/sewage costs for many hospitals.
Energy Efficiency Opportunities in Ontario Hospitals
31
Projected Data
The average values for responding hospitals were used to extrapolate the following
estimates:
Using average energy intensities for each hospital type and multiplying by the number
of hospitals in each classification the estimate for total energy use in Ontario hospitals
is:
Total # of
Hospitals
Addiction/Mental
Health
Continuing Care/Rehab
Community
Teaching
Small
14
Projected
Total
Annual
Electricity
(kWh)
98,728,406
4.81%
104,486,344
143,998,954
2.25%
1,321,045,261
1,931,319,117
30.15%
2,590,265,986
3,766,932,286
58.81%
82,111,406
172,494,540
254,605,946
3.97%
2,007,292,578
4,397,961,823
6,405,254,401
39,512,610
64
610,273,856
22
1,176,666,300
50
209,669,692
Projected
TOTAL
Annual
ENERGY
(ekWh)
308,398,098
8
TOTAL PROJECTED ENERGY FOR
ALL HOSPITALS
Projected
Total Annual
Heating
Energy
(ekWh)
The energy intensity of teaching and research hospitals was the most intensive at 2.79
GJ/m2 (71.99 ekWh / ft.²).
Although Ontario’s teaching and research hospitals represent 14% of the total
number of hospitals (22 of 157) their projected energy use is approximately
58.81% of total energy consumed. That percentage is consistent for both electrical
energy (58.6% of projected total) and heating energy (58.8% of projected total).
Energy Efficiency Opportunities in Ontario Hospitals
32
The chart below shows total energy use in Ontario’s hospitals.
4,000,000,000
3,500,000,000
3,000,000,000
ekW h
2,500,000,000
2,000,000,000
1,500,000,000
1,000,000,000
500,000,000
0
alth
ehab
are / R
ntal He
e
C
M
g
d
in
u
ion an
Contin
Add ic t
u nity
Comm
Surveyed Hospital Total Energy
Energy Efficiency Opportunities in Ontario Hospitals
ing
Teac h
Sm all
Projected Total Energy
33
THE BRITISH COLUMBIA MODEL
Green Buildings British Columbia - Encouraging Institutions to Retrofit for
Energy Efficiency
Green Buildings British Columbia (GBBC) is a provincial initiative enabling British
Columbia’s education and health care agencies to dramatically increase the
performance of their new and existing buildings through the New Buildings Program and
the Retrofit Program. In 2000, the crown corporation launched the program to support
renovations that improve the energy efficiency of schools, colleges, universities and
health-care institutions. In addition, many of the projects have led to improvements in
lighting, air quality and comfort levels for building occupants.
This initiative is funded by the BC Ministry of Advanced Education, Ministry of
Education, Ministry of Health, BC Hydro and BCBC. The program encompasses all
provincial demand management programs with GBBC providing coordination. The
voluntary program provides a framework for facility and equipment improvements in
educational and healthcare institutions in which capital cost is paid for by the utility
savings the projects generate. The program is delivered at no cost to health, education
and advanced education provincially funded agencies.
The program’s role is to:
•
Accelerate the pace of efficiency-based retrofits in these institutions
•
Provide safeguards that help protect the financial interests of the
province and participating financial institutions
The program provides support to organizations in identifying energy reduction
opportunities such as, direct support and advice on Local Distributing Companies
(LDC)/government programs for opportunity assessments.
The program offers two approaches for project implementation – an Energy Service
Company (ESCO) approach and an unbundled self-financing approach. All potential
contractors are pre-qualified through the program. To help clients select qualified
retrofit companies, GBBC screens contractors, verifying their expertise and financial
status. A list of qualified firms on the Internet includes companies offering engineering
design, project management, installation, and monitoring and verification services. “The
Qualified Bidders List reduces the risk of having firms that can not complete a project
being selected” states Brian Miltmore Client Liaison Manager, GBBC - Retrofit Program.
GBBC provides contract documents are standard for all projects. These documents are
typically aligned in favor of the owner’s needs as compared to what they might have
Energy Efficiency Opportunities in Ontario Hospitals
34
individually negotiated with the contractors. Projects are tendered to a minimum of
three pre-qualified program approved bidders.
The program enables client institutions to borrow money at discounted interest rates,
and obtain either performance guarantees or insurance coverage guaranteeing specific
energy savings. Here is how it works: clients borrow money from a $50 million pool of
credit established for the program by the Royal Bank of Canada, the successful bidder
in a competitive tendering process. Loans are provided at terms more attractive than
applicants could negotiate themselves – typically for rates below prime. Typically the
rates are about 0.25% above provincial borrowing rates. In comparison
educational/health care organization borrowing rates are about 2% above provincial
borrowing rates and ESCO are about 3% to 4% above provincial borrowing rates.
Performance guarantees are also available from participating energy-service
companies. Alternatively, institutions can purchase policies to insure project
performance; the brokerage firm of Morris and McKenzie won the right to underwrite
retrofit projects.
“The key to our success has been the programs ability to overcome the two biggest
obstacles to implementing retrofits: cost of capital and management of risk,” says Orest
Maslany, manager of GBBC.
“The GBBC program stream-lines many government and organizational requirements,
addressing them in a pre-planned or authorized approach. This simplifies and clarifies
responsibilities for ministry approvals to borrow. This also reduces the hesitation on the
part of organizations to engage in what is often perceived as another complex process
that they have insufficient resources to do,” says Brian Miltmore Client Liaison Manager,
GBBC - Retrofit Program.
As project savings are guaranteed the respective Ministry approvals are only required
for approvals for borrowing money. Approvals typically are received within two weeks
of submission.
Since introduction in 2001, there have been capital investments of approximately $111
million resulting in annual savings of about $12 million. In comparison from 1990 to
200 the sector invested about $18.6 million in self-financed energy retrofits prior to the
program.
“Our program minimizes the risks-both real and perceived – associated with retrofitting
for energy efficiency,” Maslany says. “Provincial institutions can confidently invest in
portfolio-wide projects that pay for themselves within a few years and generate savings
for many years to come.”
To ensure its own long-term success, the Retrofit Program focuses on outreach,
educating officials of provincial institutions about the substantial benefits of retrofit
projects. To date, more than 70 on-site workshops have been delivered to school
Energy Efficiency Opportunities in Ontario Hospitals
35
districts, post-secondary institutions and health authorities. Each workshop is delivered
to representatives from a client's operations, procurement and finance departments,
and, in some instances, members of the institution's board of directors.
The GBBC website also offers a range of other materials, including case studies, how-to
guides, and template RFPs and contracts.
"We're determined to make it as easy as possible for our clients to implement projects in
all of their buildings," says Maslany.
The Retrofit Program has succeeded in accelerating the pace of retrofits. In its first year,
only a handful of institutions took part the program. To date, more than 20 institutions
have participated, with a total of almost 700 buildings.
BC Hydro Power Smart Partners Program – Energy Manager
BC Hydro has innovative programs to assist business, institutional, manufacturing and
industrial customers who have large or numerous facilities, or have complex energyusing processes. An innovative component of the Power Smart Partners Program is in
providing funds towards hiring an Energy Manager.
The program provides funding of up to $100,000 for a full time, part-time or an external
consultant third party to be the energy manager. In the case of schools, universities,
colleges and hospitals they do not require matching funds as other businesses would.
Organizations can become a Power Smart Partner if you have spent at least $50,000 on
electricity in the last year.
An Energy Manager can identify energy efficiency solutions, manage the
implementation of energy-saving projects and develop operational and maintenance
procedures that will enhance the efficiency of your equipment. In addition, an Energy
Manager can develop plans that will allow your employees to implement and sustain
ongoing energy efficiency practices.
The program is intended to assist organizations identify energy efficiency opportunities
that exist in their operations. The program recognizes that many organizations may not
have the human or financial resources available to identify and implement those
opportunities. To overcome this barrier, BC Hydro provides Energy Savings Opportunity
Identification funding for Power Smart Partners to hire an internal Energy Manager or
utilize the services of an outside consultant to help identify energy efficiency solutions,
manage the implementation of energy saving projects, and develop operational and
maintenance procedures that will enhance the efficiency of equipment. In addition, an
Energy Manager can develop plans that will allow employees to implement and sustain
ongoing energy efficiency practices.
Energy Efficiency Opportunities in Ontario Hospitals
36
A dedicated resource to assist with:
•
Benchmarking your facility’s energy usage
•
Developing an equipment load inventory
•
Conducting a walk-through energy survey of your facility
•
Creating an energy management plan for your facility
•
Preparing budgets and business cases for energy efficiency projects
•
Managing the implementation of energy efficiency projects
•
Training employees on energy-saving measures
•
Better management of your facility’s energy use
•
Reduced operating and maintenance costs resulting from energy-saving
measures
A dedicated Energy Manager is assigned to one Power Smart Partner. This is usually a
large operation with multiple facilities or with complicated systems, such as a hospital or
large industrial site. Dedicated Energy Managers may be assigned for up to one year.
BC Hydro will consider extending the term to subsequent years if a review of your
objectives and progress shows that this is appropriate. Part-Time Energy Managers are
assigned to a number of Power Smart Partners, usually those with smaller or less
complex facilities. Part-Time Energy Managers will spend a minimum of three months
with each Power Smart Partner over the period of one year.
Energy Efficiency Opportunities in Ontario Hospitals
37
SUCCESS STORIES
HEADWATERS HEALTH CENTRE
Canada's Energy Efficiency Awards 2005 - Honorable Mention (Retrofit or
Renovation Projects – Government and Institutional Buildings)
The Headwaters Health Care Centre is demonstrating how to combine energy efficiency
and environmental awareness to free up precious dollars for patient care.
Upgrades to lighting and mechanical systems and a new energy management system
will save the hospital over $150,000 every year. And if energy costs rise at the
Orangeville Ontario facility, so will the savings. The project was implemented between
May 2003 and May 2004.
“Our energy costs have doubled since 1997,” said Bob Baynham, the Centre's
President and CEO. “This put pressure on our budget and compelled us to look for
energy efficiencies.”
A $6,000 Energy Innovators grant from Natural Resources Canada funded a study to
learn how the 108-bed hospital could reduce its energy costs. Honeywell, a global
energy management and equipment company, signed a $1.15 million energy
performance contract with the Centre.
Under the contract, existing systems were replaced with new equipment and cuttingedge energy management technology. The cost of the replacement systems is paid for
by the savings reaped from the new, more energy-efficient systems. The project is
expected to cover the initial investment in 7.4 years. If it generates less than $156,330
per year in savings, Honeywell will make up the difference.
“The idea of a performance contract really made sense. It's a great success story to be
able to say that the upgrades will help the environment, save us money and pay for
themselves,” said Baynham.
The project will save about 13,500 gigajoules of energy per year (enough energy to light
135,000 100-Watt light bulbs continuously for 12 days). It will also cut the hospital's
GHG emissions by 800 tonnes.
“Getting these results was a challenge. The hospital is built on the side of a hill, which
means it's not a typical box-shaped building,” said Baynham.
But hospital staff and Honeywell Consultants were able to come up with a three-phase
plan to address the hospital's specific needs.
Phase One upgraded the lighting to more energy-efficient bulbs. Motion sensors were
also installed to automatically switch off lights. Sensors also measure natural light levels
Energy Efficiency Opportunities in Ontario Hospitals
38
to allow lights to be dimmed if sunshine can make up the difference. Together, both
types of sensors have reduced electrical consumption by 16 percent.
Phase Two covered a mechanical upgrade, including a new high-efficiency boiler. The
hospital air supply can now be controlled more precisely with a series of variable-speed
fans and dampers. This reduces energy consumption by reducing air flow to
unoccupied areas.
Phase Three was the energy management system upgrade. This new computerized
system allows for optimal control of the heating, ventilation and air conditioning system
and the high-efficiency boilers. Ambulance-bay doors, for example, are often left open
for extended periods. The computer will shut off the heater if the bay doors are open
after a certain length of time.
Advice to Others
Dan Pitcher – Manager, Plant Operations for the Headwaters Health Centre offers the
following advice to others on starting an energy conservation program:
•
Conduct an energy opportunities study to identify major energy consuming
equipment and opportunities for improving efficiency
•
Do your homework to ensure you choose the right contractor
He suggests that eight basic steps comprise an Energy retrofit solutions program:
•
Identify inefficient use thought analysis of historical utility consumption and
evaluation of building design, occupancy and operation
•
Identify opportunities to reduce non-utility operation cost through analysis of facility
budgets, operating and maintenance processes, procurement practices, etc.
•
Design changes to mechanical and electrical equipment, systems and/or building
operations
•
Install and commission efficiency improvement measures
•
Upgrade the level of knowledge building operators possess
•
Continue with a customized maintenance and repair program to ensure operational
performance and success
•
Provide a post construction reconciliation report detailing projected saving (a report
card)
•
Have contractor Guarantee both the annual savings and the installed systems
performance
Energy Efficiency Opportunities in Ontario Hospitals
39
THE OTTAWA HOSPITAL
2005 OHA Energy Efficiency Award
Sponsored by Natural Resources Canada
The Ottawa Hospital (TOH) has embarked on an ambitious long-term facility
infrastructure renewal plan, designed to significantly improve the efficiency and quality
of the hospital’s buildings and systems. The Ottawa Hospitals ambitious long-term
facility renewal plan has cost the hospital $17 million in infrastructure upgrades, but has
substantially reduced natural gas, electricity and steam consumption by $2.7 million
annually from the hospital’s current utility costs of $14 million per year. Through the
implementation of the program TOH will reduce steam consumption by 40%, electricity
by 18% and water by 8%.
The Ottawa Hospital began by starting the development of an Energy Conservation
Program. First with a team with the right skills was selected to manage and execute the
program. The team established objectives, priorities, and timeframes and utilized a
historic database to evaluate Energy Conservation Opportunities. Subsequently they
partnered with and energy management company to conduct a detailed audit. After the
Energy Conservation Opportunities and the estimated savings were determined the
team issued a report and consulted with independent engineering companies to adjust
and fine tune the objectives and priorities. In addition, the report was reviewed by an
Energy Auditor to finalize the report and answer all related questions to allow an
agreement to be reached with the energy management firm for the Energy
Conservation Opportunities to be implemented. Through the agreement all savings are
guaranteed by their selected energy management company. Metering will allow TOH to
verify savings.
The project will take 18 months to implement and began in November 2004. Key
components of the project included:
•
Lighting retrofits at all three campuses and two parking garages
•
A new state-of-the-art building automation system for all three campuses
•
Replacement of some chillers with more energy efficient, environmentally friendly
non CFC chillers
•
Replacement of existing motors with more efficient ones
•
Sealing the building envelopes to reduce drafts and prevent energy leakage
•
Installation of water conserving fixtures and reduction in process water usage
Energy Efficiency Opportunities in Ontario Hospitals
40
Additional benefits of the project include:
•
The retrofit will ensure that recommended standards be met for lighting, indoor air
temperatures and humidity
•
Training for all new equipment to TOH operators by professional trainers
•
Reduced maintenance requirements, reducing operator workload
•
Development of an Awareness Program that will facilitate a better understanding of
the Energy Performance contract amoung hospital personnel, visitors and the
community
The hospital is now planning an additional energy project, worth approximately $17
million that foresees the installation of a 4.6MW gas turbine cogeneration plant as well
as numerous energy efficiency measures (steam-to-hot-water conversion) in order to
make the hospital more energy efficient, and self-sufficient. These initiatives are
expected to save the hospital an additional $3 million in energy costs.
Advice to Others
Faris Rashid, Energy Manager at The Ottawa Hospital states that “we keep tracking
the Energy charges and they are increasing everyday, so we have to increase the
Energy budget accordingly. We have to provide awareness that we should "Do
something" and not only increase budgets and "Do nothing".
A plan should be put together which can be summarized as follows”:
•
Assign the Energy management responsibility to a person and not to include the
Energy management with other responsibilities for another engineer or manager
•
Contact NRCan to attend the Energy efficiency workshops offered to the public.
•
Start an awareness program for the "no cost" opportunities with the employees.
NRCan can be helpful as well
•
Start presentations to the senior management for the impact on reducing the Energy
consumption and the impact on budget and environment
•
Check with the COO if any funds can be made available to start projects like
"lighting" or "building envelope"
•
Contact some ESCOs to provide audits to estimate the amount of Energy units that
can be saved and the incentives to be received from NRCan and others as a result.
ESCOs can provide the financials if the Hospital can't find the necessary funds for
the project
Energy Efficiency Opportunities in Ontario Hospitals
41
•
Presentations based on the audit to the senior management should resume based
on Operations, Financial analysis, strategic view and to approve the Energy
Efficiency opportunity and to go ahead
•
Start building the "Green teams" in the facility to promote for the Energy savings
opportunities in the different departments
Energy Efficiency Opportunities in Ontario Hospitals
42
BLUEWATER HEALTH
2005 OHA Overall Leadership Award
2004 OHA Healthy Hospital Innovators Award
Bluewater Health’s journey to become a leader in the area of environmental
stewardship began with the establishment of its Green Team in the spring of 2002. The
Green Team’s creation has ensured that Environmental Management System (EMS)
requirements established would be implemented and maintained in accordance with the
hospital’s environmental policy. As a result, the team established a goal to become the
first silver LEED (Leadership in Energy & Environmental Design) certified health care
facility in Canada.
Extensive community input was collected through a series of three visioning sessions to
determine the direction of the capital build. The result was a ‘visioning document’
containing the project's directives and a project vision statement. Everyone had a voice
–hospital staff, hospital management, volunteers, community groups, industry
representatives - even the surrounding neighborhood had representation.
“As the single largest consumer of public monies, leadership responsibility in the areas
of energy efficiency, pollution prevention and the creation of sustainable environments
should rest with no other than the hospitals of Ontario; to such is the commitment of
Bluewater Health,” said Don Hall, Vice President, Facilities, Planning and Development.
“The development of the capital project vision document articulated and supported our
initiatives to build Canada’s most environmentally friendly and energy efficient hospital,”
he added.
The LEED system rates a building’s environmental performance by awarding credits in
six main categories for actions during its construction and subsequent use:
•
Sustainable Sites
•
Water Efficiency
•
Energy and Atmosphere
•
Material and Resources
•
Indoor Environmental Quality
•
Innovation and Design Process l u e w a
In June of 2002, the capital project team undertook the development of a project
visioning document for the Sarnia hospital building project. The Redevelopment Project
was directed by the Health Services Restructuring Commission (HSRC) in October of
1997. The directives required the consolidation of the Sarnia General Hospital (Mitton
Energy Efficiency Opportunities in Ontario Hospitals
43
site) to the St. Joseph’s Health Centre site (Norman site). Coordinated design efforts to
develop the facility’s current plan began in earnest in March of 2002. The current
project scope and costs is about $175 million (including F&E and Own funds projects).
The project incorporates approx. 310,000 sq. ft. of new construction and approx.
150,000 sq. ft. of renovated space.
The targeted energy use for the new building is 20% below the energy use of a code
compliant, building designed to ASHRAE 90.1. This will result in an annual energy cost
savings for the new building of $185,000 to $225,000. These operational cost savings
yield a payback for the LEED Silver rating of 4 –5 years on a $1.1M investment, with
many other benefits not yet financially quantified.
A common perception of sustainable design however, is that it is difficult to reconcile
green design strategies with complicated code and technical requirements. “It is simply
not the case,” says Tye Farrow, Partner in Charge of Design - Farrow Partnership
Architects. “The initial cost of implementing LEED initiatives are limited, however these
will be recouped in operating cost savings within five years.” In addition, the
incorporation of sustainable design principles provides long term operational efficiencies
that include energy conservation, cost savings and a healthier work environment that
leads to an increased ability to attract and retain talented medical staff in this
competitive environment. With a constant focus on using green design to creating
positive healing and working environments, “energy and resource consumption” says
Farrow, “are perhaps the most challenging issues in a hospital environment because of
the energy-intensive nature of these buildings. By maximizing energy performance
through sound design solutions, we not only minimize environmental impacts but we
also minimize the long-term impacts on the operating budget.”
To realize the silver rating and become a symbol for the community, the project features
many innovative solutions including: the incorporation of modular wall and furniture
systems; a high R-value building envelope; low volume plumbing fixtures; extensive
glazing and shading devices in the main atrium to realize passive solar gains; internal
light shafts; and used extensive energy modeling to assess various systems
performances. Innovative features such as utilization of reverse-osmosis reject water
for toilet flushing, rainwater storage for irrigation help to reduce water consumption.
Patients, staff, and visitors will benefit from low-VOC interior finishes and an accessible
public transportation program.
Bluewater Health has been awarded the prestigious “Green Health Care – Overall
Leadership Award – 2005” at the OHA HealthAchieve 2005 annual convention in
November. The award, being presented for the third time, recognizes those hospitals
that demonstrate a significant organizational commitment to environmental sustainability
and to reducing environmental impact, including evidence of progress in energy
efficiency, pollution prevention and involvement with the community. “This is the
second year in a row that Bluewater Health has been recognized at the provincial level
for initiatives taking place within our organization,” said Bluewater Health
President/CEO David Vigar. “This award from the OHA further validates our strategic
Energy Efficiency Opportunities in Ontario Hospitals
44
directive to create a responsive organization with a positive organizational culture,
stewardship for the environment and focus on the safety of our patients.”
“All LEED credits have recognized environmental and social benefits. There are also
measurable financial benefits which include, reduced absenteeism and increased
productivity amongst staff, and improved patient outcomes,” said Hall.
“At Bluewater Health, we are committed to environmental leadership and to ensuring
that our organization is vigilant in protecting the environment across all of our
operations,” said Bluewater Health President/CEO David Vigar. “This award validates
the efforts and celebrates the commitment of our staff, physicians and volunteers.”
Current undertakings include the review and inclusion of infrastructure for a future CoGeneration electrical generator, which would offset boiler capacity and provide 1.5
Megawatts of power on site. The long-term reduction of CO2 emissions into the
atmosphere as a result of it’s’ implementation over a 20 year period is estimated at
100,000 metric tonnes!
Advice to Others
Don Hall, Vice President, Facilities, Planning and Development offers the following
advice to others:
•
All facilities should consider LEED certification as a minimum. The governments
recent Conservation Action Plan "Building a Conservation Culture" produced by
the Conservation Action Team under the guidance of then assistant to Minister
of Energy, Donna Cansfield states under recommendation #15 states
that "Require LEED certification for all new buildings, facilities and major
retrofits, which are eligible for provincial funding"
•
Alternatively, facilities owners should consider the incorporation of the GGHC
(Guidelines for Green Healthcare) initiatives in the building developments and
ongoing operations
•
Furthermore, each facility should during project planning allocate approximately
1% of total construction costs for the incorporation of green initiatives. This cost
should cover both LEED certification compliance and Consultant staff fees to
undertake the initiatives
Energy Efficiency Opportunities in Ontario Hospitals
45
London Health Sciences Centre and St Joseph’s Health Care, London
OHA’s Green Health Care – 2003 Overall Leadership Award:
2004 National CCHSE/OEE Energy Management Award
Canada’s Energy Efficiency Awards 2005 - Honorable Mention (Retrofit or
Renovation Projects – Government and Institutional Buildings)
London hospitals are reaping huge rewards from multi-phased energy projects. St.
Joseph’s Health Care, London and London Health Sciences Centre together have cut
annual energy consumption by over 130,000 gigajoules (enough power to light 1.3
million 100-Watt light bulbs continuously for 12 days) and reduced GHG emissions by
almost 14,000 tonnes.
The hospitals energy retrofits are also retooling the bottom line annual savings are
currently increasing from $1.8 million to over $2.3 million as two more projects near
completion in 2005/2006. Natural Resources Canada's Energy Innovators program
awarded $288,000 in grant money to London Health Sciences to complete phase II of
their project. St. Joseph’s received $79,000 in grant money from NRCan to complete
the Parkwood hospital energy project in 2005/2006.
So far, over $11 million has been invested in retrofits, with payback periods ranging
from four to six years. St. Joseph’s Health Care and London Health Sciences partnered
with Johnson Controls and Honeywell respectively for these energy projects. The
retrofits covered several campuses at the hospitals, which have enough combined floor
space to cover almost 60 football fields. They included standard measures such as
lighting upgrades; variable-frequency drives on fans; space, temperature and light
sensors; along with advanced computer controls for all these systems.
“The importance of a corporate and leadership commitment to energy management and
stewardship is essential to sustain a viable program”, said David Crockett, Integrated
Vice President, Facilities Management and Restructuring for both London Hospitals. “At
a department retreat several years ago we created a Department Purpose Statement
and an Energy Stewardship Mission Statement that clearly states our accountability to
address energy utilization, innovation, environmental sustainability and energy
stewardship.”
“A clear indication of this intention was in the past history of innovations and more
recently the joint hiring of a Team Leader for the London Hospitals Energy Stewardship
Program. Programs are often started and then lose momentum .To sustain a program
and to continuously integrate human and technology innovations requires an ongoing
investigation, learning, communication and publication process. Our Team leader role
has been instrumental in sharing and sustaining our energy savings successes.”
The physical scale of the projects and an annual $20 million plus energy bill, made
some of the retrofits ideal candidates for energy performance contracting. Under this
type of contracts, the cost of new equipment and cutting-edge energy management
technology is paid for by the savings generated once the work is complete.
Energy Efficiency Opportunities in Ontario Hospitals
46
“Energy performance contracting allows us to complete projects that are well outside
the hospitals’ capital funding capacity for this type of work,” said Mark Read, Team
Leader of the hospitals’ citywide Energy Stewardship Program.
Funding is only one of the unique challenges met by healthcare organizations in the
face of projects like these. Because hospitals operate 24/7, adjusting hours of operation
or load shifting are not options available to the hospital for energy saving. Temperature
settings and medical equipment selection must meet medical requirements before
energy efficiency is considered. Large amounts of fresh air must be brought into
buildings to reduce odours. And room air pressure must be maintained to avoid the
spread of infection. While most buildings have one internal climate to maintain,
hospitals have several micro-climates that exist within the building, each with different
HVAC requirements.
What is more, while inconveniencing workers in an industrial plant or office building
might be acceptable in some situations, it is unacceptable for a healthcare organization:
the level of patient care must be sustained throughout the entire process.
One of the creative and innovative aspects of the work done at the London hospitals
involved getting extra usable power from the hospitals' incoming high-pressure steam
system. The system was initially designed to produce steam at a much higher pressure
than the hospitals would use. A new steam-driven turbine will take the place of the
pressure-reducing valve, allowing an extra two megawatts of electricity to be generated
while lowering the steam pressure (a megawatt is a 1,000,000 watts).
“The steam turbine is an addition to our present co-generation system currently
producing five megawatts of electricity with a Rolls Royce jet engine. In 2006, our
capacity will jump to seven megawatts simply by capturing what is essentially two
megawatts of free energy. We'll generate enough electricity to power approximately
5,000 average-sized homes in London,” said Read.
The technical innovation of the hospitals approach was matched by its attention to the
human side of the project.
“We involve the staff from a communication perspective so they can understand what
the energy retrofits mean to the hospitals. We encourage staff to ask questions and
make suggestions so they can take some ownership in our energy management
efforts,” said Read. “Along with training on the new systems, focusing on staff also
helps us with basic energy-saving housekeeping issues that fall outside the retrofit
project.”
This comprehensive approach has been a defining feature of the hospitals commitment
to energy conservation since the 1970s.
Energy Efficiency Opportunities in Ontario Hospitals
47
“We feel that this work is the professional and responsible thing to do,” said Read.
“We're at a point where we can start to share our successes and provide help to other
organizations like ours.”
The hospital was also the recipient of the 2005 London Chamber of Commerce,
Environmental Award at the Business Achievement Awards.
Advice to Others
Mark Read, Energy Specialist, LHSC/SJHC offers the following advice to others:
•
Educate the senior leadership in advance - Start out by educating leadership as
to the price of energy, what it is costing the hospital, how energy is used in the
hospital, what are the effects of events such as hurricane Katrina etc. Do this
consistently over time to have them better educated on the subject and to
position yourself as the “expert” so that a trust is established when it comes time
to approach them with a proposal
•
Explore all funding potential - many people are intimidated by the paperwork
involved in this process. Become an NRCan energy innovator and a program
officer will help you with the paperwork. Program resources are available and
practical help to advance seed funding for projects is available. LHSC received
$288,000. SJHC $79,000. Also speak to the local utilities - gas companies will
offer grants for gas reduction, new equipment, audits, steam trap surveys etc
•
Select an energy partner that you feel comfortable with. Often you can have an
energy management company look at your bills and take a quick walkthrough
and be able to propose a project with little or no cost. If you need a more costly
detailed approach the again, energy audit funding is available through NRCan
funding and local utility suppliers. Look at case studies from other hospitals that
have used the company in question and speak to the project managers for their
opinions
•
Explore financing options - Bonds, Energy Performance Contracting, 50% capital
and 50% performance contract etc. It doesn’t need to cost you anything up front
if that's the way you decide to go. Projects can be paid back through
guaranteed savings
•
When taking the proposal forward make sure to show the “Life Cycle Cost” of the
project and not just the annual savings or simple payback. If newer more
efficient equipment will last for 30 years - show the total savings out to 30 years
and the parallel scenario of not implementing the project
•
Finally, when addressing the finance department - give them the bottom line
right up front and work out the details from there. It is important to demonstrate
the delivery on project savings and build credibility for more complex programs
as you move forward
Energy Efficiency Opportunities in Ontario Hospitals
48
•
Consider creating an energy stewardship program to create ongoing awareness
and engagement
Energy Efficiency Opportunities in Ontario Hospitals
49
UNIVERSITY HEALTH NETWORK
With over 400,000 square metres of floor space, buildings of various ages and the
complex nature of work done on-site, realizing energy savings at University Health
Network’s (UHN) hospitals poses a unique challenge. UHN began implementing large
energy conservation initiatives in 1994 with a $10 million project that reduced the
Hospital’s annual utility consumption by over 11 million gigajoules through more efficient
use of electricity, steam and natural gas. More recently, however, there have been
several projects that continue to underline UHN’s commitment towards energy
efficiency. These projects include:
•
The installation of a steam heat recovery system at UHN's Princess Margaret
Hospital completed in April 2002. The system has reduced the Hospital’s steam
consumption by an estimated 7.5 million pounds (approximately 11,280 GJ) per year
with an associated decrease in CO2 equivalents emissions of approximately 576
metric tonnes
•
The audit and repair of steam traps at the Toronto General, Toronto Western and
Princess Margaret Hospital was completed in 2003. The repair and replacement of
faulty steam traps, helped UHN reduce its steam consumption by a combined
amount of approximately 37.8 million pounds per year (approximately 56,230 GJ),
which translates into an estimated reduction in related CO2 equivalents emissions of
2,873 metric tonnes. The audit is scheduled to be repeated in late 2005 or early
2006
•
The completion of a retrofit installation of an innovative, new lighting control system
into the Toronto General Hospital's R. Fraser Eliot (RFE) Building in the summer of
2004. Utilizing dimmable ballasts, daylight sensors, occupancy sensors, timers and
software that allow the control of lights from desktop computers, the lighting control
system has resulted in an annual savings of approximately 688,000 kWh with an
associated reduction in CO2 equivalents emissions of approximately 203 metric
tonnes per year. UHN won a 2005 Energy Efficiency Award from Natural Resources
Canada for installation of the lighting control system
•
The installation of boiler economizers at the Toronto Western Hospital, which are
expected to reduce natural gas consumption by over 650,000 m3 per year, resulting
in an estimated reduction in related CO2 equivalents emissions of 1,278 metric
tonnes
•
A communication and awareness program that has included the “Isn’t it time you
gave a FLICK” poster campaign; regular publication and distribution of the Bright
Ideas newsletter; energy conservation information posted on the Hospital’s
Environmental Management intranet site; and, detailed monitoring of utility
consumption through invoices and interval meters with regular reporting to Senior
Hospital Administrators
Energy Efficiency Opportunities in Ontario Hospitals
50
As well, UHN is a registered member of the Office of Energy Efficiency (OEE) run by
Natural Resources Canada. UHN’s accomplishments were also recognized by the
OHA, which awarded the Hospital a Green Health Care Award for Energy Efficiency in
2003.
Advice to Others
Ed Rubinstein - UHN Environmental Coordinator, UHN suggests that improving energy
efficiency always begins with awareness. You need to be monitoring tracking your
utility bills on a regular basis - knowing what you spend and how you spend it.
Networking with others to:
•
compare your utility usage
•
share ideas with others
•
develop an energy management strategy
Awareness of utility usage and pricing impact also needs to be communicated within
your organization – from the executive through to front-line workers. It is especially
important to get operations staff responsible for the day-to-day operation of the facility
involved – they are a key to successful implementation.
One of the challenges in the hectic environment we work in is the construction activity
but it is important to dedicate the time and resources to ensure that energy efficiency is
planned and incorporated into all projects. When considering energy efficiency projects
it is also an important to consider all aspects of total life-cycle costs.
Energy Efficiency Opportunities in Ontario Hospitals
51
ST. MICHAEL’S HOSPITAL - TORONTO
St. Michael’s has always been a leader in the Energy Management field. Most recently
in 1995 St. Michael’s entered into an agreement with an energy management company.
Estimated savings for retrofitting T12 to T8 lamps, installing DDC controls yielded
approximately $500,000 per year.
In 2003 with rising prices of steam, thermal energy conservation projects became more
economically feasible. An energy management company from Quebec was brought in
to do an energy study concentrating on steam and water. Preliminary studies estimated
an annual savings of energy at $1.3 million per year. Once the final study was
produced the savings rose to$1.8 million per year.
Based on this analysis eight areas were identified to reduce energy consumption and
therefore as a result reduce the cost associated with this reduction. The eight areas of
improvement are as follows:
•
Humidification – Replacement of steam injection by water atomization
process. This consisted of installing a high-pressure reverse-osmosis
humidification system in the ventilation systems in the hospital. This measure
involves eliminating the steam atomization nozzles, lines and traps. This will also
eliminate heat losses throughout the system
•
Conversion of heating from steam to high – temperature hot water. This
measure includes installing three flooded hot water heat exchangers producing hot
water at a temperature of 180oF-200oF for heating mainly in the colder winter
months. This high temperature hot water will supply coils in the fans, provide heat to
the glycol system on the roof and can also be used to blend hot water in to the low
temperature hot water loop in winter when the demand is low from the heat recovery
chiller. Most steam will be eliminated inside the hospital except for areas such as
kitchen, laundry, sterilizers and central processing depot
•
Domestic Hot Water Conversion. This measure included elimination of 15 flash
hot water heaters with 3 flooded vertical heat exchangers. Condensate from the
vertical heat exchangers and low temperature heating water will also be used to
preheat domestic water before it goes to the vertical heat exchangers as a result
reducing the amount of steam being consumed
•
City water savings. This measure produces savings by reducing the consumption
of city water and helps recover heat from 42 stand-up air conditioning units and
kitchen compressors in a closed chilled water circuit
•
Heat – Recovery. This involved dismantling two 450 ton centrifugal chillers which
utilized R-11 refrigerant and installing 3 heat recovery chillers. Low temperature
hot water from heat recovery chillers will be used for low temperature hot water
heating (reheats and radiant panel) and preheating of the domestic water
Energy Efficiency Opportunities in Ontario Hospitals
52
•
Sequencing of the absorption chillers. According to market conditions when
electricity is cheaper than steam St. Michael’s will use heat recovery chillers always
as the lead, followed by centrifugal. Absorbers will be used only as a back up.
•
Optimization of the chilled water system. There will be some modifications to the
existing chilled water systems such as removing the variable speed pump drives and
by installing them on the fan units
•
Scheduling equipment. All equipment will be checked for optimum occupancy
schedule. This cost savings method produces a no cost instant savings measure
The Quebec based energy management company has guaranteed annual savings
of $1.3 million but the estimated savings are as high as $1.8 million dollars per year.
Under the $1.3 million savings St. Michael’s hospital should save an estimated
138,161 GJ and reduce carbon dioxide levels in the atmosphere by approximately
7000 tons. The biggest part of the savings will be from the steam. The project has
been fully implemented since July and the results show that from July to November
2005 a total of $482 000, representing 80% of the $1.8 M forecast. Once
optimization is completed and the savings maximized, we are confident that will
have reached the target savings of $1.8 M. Another indirect savings is natural gas.
A reduction in steam consumption is directly proportional to a reduction in natural
combustion by the local steam provider (Enwave), thus reducing the amount of
GHG’s released to the environment. Another significant impact on this energy
retrofit is the hospital got to decommission 3 R-11 refrigeration machines totaling
1500 tons. This is a win-win situation for the hospital and the environment.
As a result of this energy project the staff at St. Michael’s Hospital has become more
energy conscious.
At Engineering Week we had an energy day devoted to the staff. Our energy
partners explained the project and how it would benefit the hospital. We also had
Enbridge, City of Toronto and Toronto Hydro give presentations on energy efficiency
and how to save not only in their place of work but also at home.
We are currently producing a quarterly newsletter for staff. The name of the
newsletter is the “Quarterly Plug” endorsed by our President and CEO. This
newsletter is for all staff it will include energy savings tips, what the hospital is doing
to promote energy efficiency and how staff can do their part in making this hospital
run more efficiently.
Advice to Others
Michael Keen – Director, Engineering and Plant Services involvement and
commitment at all levels of the organization. They increase awareness through
newsletters and events to raise environmental consciousness, awareness of cost of
energy (and means to conserve). They have a Greening Health Care Committee
Energy Efficiency Opportunities in Ontario Hospitals
53
within the hospital in which energy management is one component. For those
looking to improve energy efficiency within their facilities he suggests that:
•
Develop strong business cases – have plan upfront
•
It helps to partner with company’s that specialize in energy management
•
These partnerships must incorporate full communication to all levels of
staff to ensure understanding and commitment
•
That work considered should be to the philosophy of the hospital
•
You should ensure that you get tight guarantees, develop tight contracts
and ensure that the project does not adversely affect the quality of your
environment (is not degraded or below standards)
Energy Efficiency Opportunities in Ontario Hospitals
54
SOME OTHER SUCCESS STORIES
Hospitals have made big strides in energy efficiency through retrofit projects and
awareness programs. This has been spurred in part through the OHA Efficiency and
Alternative Energy Saving Program, which is a joint effort of OHA, Natural Resources
Canada’s (NRC) Office of Energy Efficiency (OEE), and the Canadian College of Health
Services Executives (CCHSE).
Its purpose is to assist hospitals with implementing energy saving solutions. Through
this program and other OEE programs, hospitals have accessed a range of services,
tools and financial incentives to reduce energy use, diverting more monies towards
patient care. The environment also benefits from fewer GHG emissions. The following
examples demonstrate some of the projects hospitals have launched.
Montfort Hospital in Ottawa saved $3,500 per year through small retrofit projects
including new lighting and controls, steam traps, water saving toilets and showerheads.
Royal Ottawa Healthcare Group implemented a $1.8 million energy retrofit project
saving $300,000 annually. Using an energy performance contract, the contractor
provided capital funding that was repaid out of the hospital’s annual savings.
Queensway-Carleton Hospital (QCH) has formed a strategic alliance with Johnson
Controls Inc. to introduce several energy performance improvements. The $6 million
project includes a new cogeneration unit. The savings projected from this approved
MOHLTC Own Funds project suggest a return on investment of less than seven years.
Kingston General Hospital identified $200,000 in annual energy savings for a capital
investment of $1 million. One project forecasts $95,000 in savings and a reduction in
GHG emissions of 500 tonnes annually.
Pembroke General Hospital reduced natural gas use by 56% following a power plant
retrofit. Annual savings are $470,000.
Hamilton Health Sciences launched a cogeneration project to use natural gas to
produce electricity and to use waste heat for heating and cooling. The project is owned
and financed by the Bay Area Health Trust (a commercial business Trust that seeks
business opportunities outside of core hospital business – Trust earnings are returned
to the hospital).
Energy Efficiency Opportunities in Ontario Hospitals
55
THE CONSULTANT’S EXPERIENCE:
Prior to starting his own company in 2002, Jim Jefferson – President of Sure Solutions
Inc. spent 25 years directing facility operations and redevelopment. Approximately 12
of those years were directly in the hospital sector. Energy conservation projects
included:
The Hospital for Sick Children
During the three-and-a-half years as Director of Plant Operations and Maintenance
(1995-1998) at The Hospital for Sick Children in Toronto, we had an ongoing energy
conservation program in which:
•
Electricity was reduced by 20%
•
Purchased steam / gas was reduced by 30%
•
Water was reduced by 40%
The energy conservation activities resulted in annual utility operating budget savings of
$1,750,000 (much higher now given the increased cost of utilities) despite increased
occupancy.
The program was phased in over a two-year period with three major projects. The
projects included:
•
Retrofit of approximately 30,000 fluorescent lighting fixtures reducing electricity
consumed by fixtures by 59%:
o Installing high efficiency reflectors that allowed for the reduction of lamps
by 50% (energy, supplies and labour savings)
o Replacing T-12 lamps with T-8’s
o Installation of high efficiency ballasts (including the removal and approved
proper destruction of approximately 12,000 installed and stored ballasts
containing PCB’s.
o Managing the project internally including utilizing university co-op students
for inventorying all fixtures and the temporary hiring of 10 in-house
electricians that saved $200,000 in implementation costs.
•
Replacing incandescent lamps with LED’s in all exit lights;
o As well as the obvious energy savings LED’s last about 20 years
eliminating lamp change labour;
•
Replacing all mercury-vapor and incandescent bulbs with compact fluorescent;
•
Installing occupancy sensors for non-essential corridor and stairwell lighting in
Annex (1.25 million ft.² day-use facility) – installation by in-house temporary
electricians;
•
Installing power conditioners at inductive load centers
Energy Efficiency Opportunities in Ontario Hospitals
56
o They corrected power factor with the significant benefit of improving power
quality (total harmonic distortion), extending motor life and that of
electronic equipment (obviously significant in a hospital environment),
•
Replacing all toilets in Annex facility with low-volume pressure assist type;
•
Recommissioning of toilets in one-year old Atrium facility (approx. 1 million ft.²);
•
Installation of automatic sensors on all urinals in Annex;
•
Replacement of water sealed vacuum pumps in Atrium facility with water-less
type;
•
Adding heat recovery to exhaust for HVAC systems in the Annex;
•
Upgrading Annex BAS system;
•
Steam trap program – campus wide;
•
Replacement of over-sized motors in Annex facility;
•
Installation of direct contact high efficiency water heaters;
•
Installing occupancy sensors on Operating Room air-handling units to reduce air
changes during unoccupied periods;
•
Installation of VFD’s on secondary chilled water loop pumps;
•
Automating perimeter heating pumps to automatically start / stop with outdoor air
temperature;
•
Adding CO2 sensors for outside Emergency canopy exhaust fans;
•
Installation of automation system for Annex chillers;
•
Re-programming of all BAS systems to eliminate simultaneous heating / cooling
by supply fans and optimizing programming for greatest efficiency.
•
Installation of chilled water supply to eliminate single pass through water cooled
process equipment;
The capital projects resulted in annual savings of $1,425,000. The investment of
$3,425,000 million resulted in a payback of 2.4 years. Development of an Awareness
Program and a Daily Monitoring and Tracking Program resulted in additional savings of
$325,000 per year, resulting in a total reduction of $1,750,000 in the utilities budget.
The Mississauga Hospital (now the Trillium Health Centre)
While employed as the Director of Facilities at The Mississauga Hospital in Mississauga
(1987 to 1995) the hospital was recognized as a leader in energy conservation
programs. Electrical / fuel consumption per sq. ft. was rated in the top 5% of Canadian
hospitals; water consumption was also reduced by 30% in one year with minimal capital
investment.
Energy Efficiency Opportunities in Ontario Hospitals
57
Utility conservation projects included:
•
Lighting retrofit (again using high efficiency reflectors that reduced lamps by
50%)
•
Building automation system upgrades
•
Lab HVAC redesign – VAV air supply with fume hoods controlling face velocity
control
•
Use of occupancy sensors for HVAC control in operating rooms
•
Installation of summer boiler to increase efficiency at low loads
•
Steam trap program including trap sensors tied into BAS that alarm immediately
upon trap failure.
•
Replacement of some chillers with more efficient non CFC type
•
Retrofit to VAV HVAC systems in non-patient care areas
•
Elimination of water cooled air conditioning equipment
•
Installation of water restriction devices on taps and showers
•
Implementation of an awareness program
•
Implementation of daily boiler efficiency reports
The project reduced total utility use by more than 20%.
Sure Solutions Inc.:
Sure Solutions Inc. has provided a comprehensive suite of facility management services
to assist healthcare facilities in managing, operating and constructing facilities in the
most efficient means since 2002.
“We have managed energy audit teams that have found opportunities of up to
$3,000,000 per year in hospitals. Hospitals have unique design and operational
conditions. It is important that auditors have experience in hospital operations.”
Advice to Others:
Effective energy management is not a one-time project but an ongoing program that
requires commitment at all levels of the organization and ongoing dedicated daily
processes. A planned energy management approach is necessary to ensure efficiency.
An energy management plan includes:
•
Understanding how energy is used and how it impacts overall costs on a daily
basis
•
Identifying measures for improving energy efficiency of existing facilities and
when designing new facilities
•
Keeping equipment efficient through proper maintenance and operational
practices
Energy Efficiency Opportunities in Ontario Hospitals
58
•
Improving purchasing practices for both energy and equipment
•
Improving awareness at all levels of the organization
Total lifecycle costs are an important consideration of day-to-day management of
ongoing facility operations. The major components of total lifecycle costs are energy,
maintenance and labour costs. The quality of maintenance programs has a direct effect
on both energy and labour costs. Similarly, when considering energy conservation
projects it is important to look at the impact on maintenance and labour costs.
The best time to address ongoing lifecycle costs are during planned changes to the
facility. Efficiency, reliability and maintainability should be important factors when
planning every capital project and expansion.
We have found that there are opportunities for utility savings of 15 to 30% with
paybacks of less than 5 years in most facilities.
Energy Efficiency Opportunities in Ontario Hospitals
59
RECOMMENDATIONS
There have been many studies and reports in the last several years that have shown
the potential for energy conservation savings in hospitals. The findings of this report
identify that there are tremendous opportunities to further conserve energy (as reported
hospital energy intensity has actually increased since 2003). Ontario has established a
goal of reducing electricity demand by 5% and electricity consumption by 10% by 2007.
Hospitals represent the largest government expense and have the highest energy
intensity of all publicly funded facilities.
The largest reported barrier to energy conservation in Ontario hospitals has been
identified as lack of internal resources (59.42%) and lack of internal funding (55.07%)
necessary to implement energy management programs and initiatives. Some hospitals
that did not return a completed survey indicated that the information was not at hand or
that they didn’t have the time.
In order to meet these goals and encourage conservation in Ontario Hospitals by 2007,
direct action should be taken to reduce barriers to energy efficiency and also to offer
incentive and facilitate conservation in Ontario hospitals. The recommendations are:
1. That the OPA considers the development of reporting standards for hospital utility
usage. The first step in conservation is awareness. At present no reporting
standards or processes exist for Ontario’s hospitals. Consideration to providing
grants to stakeholders to jointly develop, collect energy data and provide
benchmarking information through the establishment of an online information portal.
2. That the OPA consider partnering with stakeholders to institute a program to
increase awareness of utility usage in Ontario’s public sector as a first step in
assisting hospitals in preparing energy conservation plans and to reduce energy by
2007. The largest reported barrier to energy conservation in Ontario hospitals has
been identified as lack of internal resources (59.42%). By centralizing the program
through an association there would be the added benefit of having cumulative
analysis for Ontario hospitals. It is recommended that the program include:
•
Complete independent energy audits for each Ontario hospital in the 2006/07
fiscal year to provide:
− An itemized description of the organization’s energy consuming
technologies and operations
− A summary of annual energy usage for each of the organization’s
technologies and operations
− Identification of measures to conserve the energy used by the
organization’s technologies and in the organization’s operations and to
otherwise reduce the amount of energy used by hospitals
•
Providing best practice mentoring, coaching and support to its members through
workshops, tele-seminars and direct contact
Energy Efficiency Opportunities in Ontario Hospitals
60
•
Providing ongoing feedback to the OPA for sector wide recommendations for
implementation of identified measures to reduce electrical demand and
consumption as well as conservation measures for other utilities
This matches the intent of the province’s goal of having Ontario hospitals prepare
energy conservation plans and reduce electrical demand and consumption by 2007.
The hospital program could be considered a pilot program for publicly funded
institutions. Implementation costs could be partially offset by existing incentive
programs through NRCan and local utilities.
The programs would provide similar benefit to the identified BC Powersmart Energy
Manager Program at a significantly lower cost and produce results in a timely
manner.
3. In the May 2005 budget, the government recognized some of the challenges faced
by the institutional sector when considering energy conservation investments and
provided for new, low cost financing for municipalities, universities and governmentowned buildings. In Chief Conservation Officer’s 2005 Annual Report – Our
Conservation Challenge the recommendation was made to broaden the group
eligible to include schools and hospitals.
It is recommended that the OPA and Ontario government consider implementation
of a program similar to the GBBC program in British Columbia to encourage and
facilitate energy conservation retrofits in Ontario hospitals. The program addresses
most major concerns faced by hospitals when considering energy conservation
projects and minimizes the risks, real and perceived – associated with retrofitting for
energy efficiency. It also allows projects to proceed in a timely manner allowing
operational savings and facilitating the province’s need to meet goals for reducing
electrical demand and consumption.
4. Ontario has announced that approximately $5.3 billion dollars will be invested into
the redevelopment of Ontario hospitals over the next five years through the Renew
Ontario program. The program represents an opportunity for improving energy
efficiency in Ontario hospitals. Recent hospital projects have demonstrated that the
costs of designing to a higher energy efficiency standard can be recovered quickly
through operational savings.
It is recommended that the Ontario government consider the immediate
implementation of mandatory design efficiency standards for planned infrastructure
changes in Ontario hospitals (CBIP, LEEDS, etc.) as part of the Ontario Public
Hospitals Act, 1990 and Renew Ontario Program. The costs of operating publicly
funded institutions are primarily funded through operational funding provided by the
Ontario government. The most logical method of reducing ongoing hospital facility
operating costs is during the design and construction of new facilities.
5. It is recommended that facility related total life cycle cost impact (energy,
maintenance, labour) be evaluated when planning all capital projects. For facility
Energy Efficiency Opportunities in Ontario Hospitals
61
systems these lifecycle costs often are several times greater than the initial capital
cost over the lifetime of the facility.
It is recommended that this become part of the project application requirements
when submitting to the MOHLTC for project approval.
6. Consider incentives for daily utility monitoring and tracking programs or real time
monitoring. The Energy Innovators Initiative Health Care Survey – “Comparing
Energy Management in Canadian Health Care Facilities” - Natural Resources
Canada (December, 2001) found that “Annual utility cost intensity is directly related
to the frequency of data collection of monitoring and tracking programs; the more
frequent the data collection; the lower the energy cost intensity.” Facilities
assembling data on a daily basis reported mean energy cost intensity 14.6% lower
than the overall mean. Such programs should be considered as part of the energy
conservation plan.
It is recommended that pilot projects be considered for hospitals to implement
Monitoring and Tracking programs including the installation of real time monitoring
technologies.
7. Hospitals are an ideal application for cogeneration applications. They have
significant electrical and heating intensities due to their design. The critical nature of
their operations would benefit from additional sources of reliable and quality power
supplies. In Chief Conservation Officer’s 2005 Annual Report – Our Conservation
Challenge, the Chief Conservation Officer identified the wasted opportunity of
underused on-site standby generators. The report recommends the adoption of
CSA C282 in both the Ontario Building Code and Fire Code (specifically regarding
the allowance of natural gas feed to emergency generators in lieu of on-site fuel
storage). Existing codes and standards do not allow the presence of a cogeneration
facility to eliminate the expense of providing additional stand-alone emergency
generators. In essence, hospitals with cogeneration equipment would be required to
have three sources of electrical supply.
Due to the nature of their critical operations they require stand-by agreements with
local utilities. Currently the costs of these standby charges are an additional barrier
to implementation.
Energy Efficiency Opportunities in Ontario Hospitals
62
Submitted to the Ontario Hospital Association
Sure Solutions Inc.
1751 Lampman Ave. Unit 1
Burlington, Ontario L7L 5W2
Telephone 905-330-8358
Contact: Jim Jefferson,
Energy Efficiency Opportunities in Ontario Hospitals
63